Napping, Pizza, Carbon Monoxide – PediaCast 309

Show Notes

Join Dr Mike in the PediaCast Studio for more news parents can use. This week’s topics include eating fish while pregnant, napping & memory, re-evaluating screen time, the problem with pizza, celiac disease on the rise, and carbon monoxide poisoning.

Make Safe Happen
Eating Fish while Pregnant
Napping & Memory
Re-Evaluating Screen Time
The Problem with Pizza
Celiac Disease on the Rise
Carbon Monoxide Poisoning

Contact Dr Mike – Show Questions, Comments, Topic Ideas
Nationwide Children’s – Request an Appointment or Referral
Nationwide Children’s – Non-Urgent Medical Questions


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 309 for February 18th, 2015. We're calling this one "Napping, Pizza, and Carbon Monoxide". You know it's going to be a good episode of the program when you're talking about naps and pizza, just some food for thought there.

I want to welcome you all to the show. It's a News Parents Can Use Edition of the program lined up for you this week. Of course, I'll get to a rundown of the entire line-up in a moment.

But first there was a little controversy in the world of social media. A few weeks back, it stemmed from a commercial that aired during the Super Bowl. You may have seen it, Nationwide Insurance, who by the way is a generous supporter of Nationwide Children's Hospital. You may have already figured that one out.

Anyway, Nationwide Insurance ran an ad for their Make Safe Happen campaign, which includes a website at, and an app for iPhone and Android. Whether you think the ad was appropriate for the Super Bowl slot or not — because that's what the controversy was all about — regardless of which side of that controversy you fall, I think we can all agree that the safety of our children is a pretty important thing. Who doesn't want to create a safe living environment for their kids? It's important.

Now, of course, we also don't want to be unrealistic. I mean, you don't want to wrap our kids in bubble wrap, which has dangers of its own like suffocation, right? You know what I mean.



Dr. Mike Patrick: You want them to be safe, but kids still have to be kids. They need to explore and run and jump and play. Really, there's an element of risk in everything we do. You can't protect your kids a 100% and still let them be kids. I think that's something else we can all agree on. But there are some simple and practical things that you can do to minimize that risk in your home, in your car, when you're out and about, when your kids are playing outside.

The app, the Make Safe Happen app, it really concentrates on your house. It goes room by room and has some great tips and guidance for making every room safe in an age-appropriate way, so it's customizable and based on the age of your children, and it's free. It really gets down to the nitty-gritty with helpful hints on such things as window guards, cord shorteners, smoke alarms, fire extinguishers, oven locks, outlet covers. It covers the bathroom, bedrooms, kitchens, living rooms, even stairs and hallways. It even suggests specific products, with links to where you can find those products.

Again, the app is free. It's been made possible by the good folks at Nationwide Insurance who truly do care about the safety and well-being of children regardless of what you may have heard after the Super Bowl commercial. Social media can be a cruel world with a lots of grown-up bullying. I think we can all agree on that one, too.

But the bottom-line is this. Nationwide truly cares. They want your children to be as safe as possible, but still letting them be kids. The app is a great way to figure out some practical ways to protect your children in the place where they spend a good portion of their lives — at home.

So be sure to check that out, Make Safe Happen. And I should have mentioned this right from the get-go. The app is also brought to you by child safety experts here at Nationwide Children's Hospital. So head over to or download the app for iPhone and Android. It's free and chockfull of great information. Make Safe Happen, brought to you by Nationwide Insurance and Nationwide Children's Hospital.


Also, don't forget our blog, 700 Children's, and you'll find it at We really rely on the collective expertise of our entire medical staff, not just doctors but lots of medical professionals. So we get lots of different looking at things through different lenses, that's what I'm trying to say. So you get different perspectives. That's the word my brain was trying to find.


Dr. Mike Patrick: Some recent topics include easy ways to prevent seasonal depression. Of course, that's important this time of the year, especially in the Midwest, where sometimes we can go days without seeing the sun. Bringing your baby home, the one reason you should donate breast milk, healthy meals and snacks for busy athletes, and then bed bugs 101. That's the one they gave me. Always great topics, and they say, "Hey, Mike, why don't you write a blog post about bed bugs?" So I did, Bed Bugs 101.

I also have a couple of other posts that will be there soon — one on RSV and bronchiolitis — and another on circumcision, which always promises to be a controversial topic. So look for those soon, and plenty of other great topics at

All right, so what are we talking about this week on this program? After all, that's why you stopped by. First up, eating fish while pregnant. You've heard you should eat more fish. It's good for you. But what about the mercury content, and what about eating fish when you're pregnant? What's the effect of the mercury on your developing baby? You've probably been told to avoid fish when you're pregnant. But is that advice really based on evidence? New study from the Seychelles sheds more light on the topic.

Then, napping and memory. So this is a story that I was really happy to cover because I enjoy a good nap now and then. And any evidence that grants me permission to nap a little more, well, that's right fine in my book. Now, to be clear, this is a study on baby napping and how naps affect learning and memory, but if the investigators wanted to expand out their project to include adults, and they do mention adults at the end of the study, I'd say enroll me. That's coming your way — naps and memory.


Then, we're going to do a little re-evaluation of screen time. We talked about screen time quite a bit on this program. We've covered the most recent guidelines from the American Academy of Pediatrics. And you know we talk about eating meals as a family, playing games as family, getting outside as a family, putting down those screens and interacting with each other, but a research team in Australia, they say not so fast. Not all screen time is bad, and maybe it's time we stop lumping all screen time together and start separating it out in good screen activities and not-so-good screen activities.

Their proposition really makes some sense and we'll explore it together.

Then, the problem with pizza. So as much as I was looking for to covering the news story about naps, I was little hesitant with this one, worried with what the investigators have to say about pizza, because I love pizza. We eat pizza at least once per week in our house. My son works at a pizza joint and whether it's New York style or Chicago thick crust, the national chains or regional pizza shops like Donato's and La Rosas in my neck of the woods, or the one off mom and pop pizza shops, we love those places. In our family, we love pizza.

I knew the gist of the story was that pizza's packed with calories and sodium. I really didn't want to hear it, but I know it's true. But then on the other hand, you got to live a little, you know. It's like the Make Safe Happen business. We want our kids to be safe, but you still got to let them be kids. I want to eat healthy, but I will still want some pizza on a regular basis. So we'll see if we can strike a balance together on that one. We'll probably make the nutritionist cringe in the process, but we'll see how that goes.


Then, Celiac Diseases on the rise. You know, we devoted an entire episode to Celiac Disease in the past. We're not going to rehash the nuts and bolts of Celiac Disease and all things gluten, but I will be sharing some numbers that shed light on the rising incidents of the disorder. We also attempt to answer the question, is the incident really rising or are we just getting better at recognizing and diagnosing Celiac Disease? So that's coming your way.

If you are interested in the nuts and bolts of Celiac Disease — the cost, symptoms, diagnosis, treatment, long-term outlook, that sort of thing — stay tuned and I'll share how you can find and have a listen to our great big Celiac show with Dr. Ivory Hill.

Then, finally, stick around at the end of the program for my final word on carbon monoxide poisoning. We'll talk specific ways to stay safe around combustibles, symptoms of exposure to this dangerous gas and what you should do if you've been exposed or think you've been exposed.

So a lot's coming your way today. Don't forget if there's a topic that you like us to talk about or if you have a question for me, or comment for the show, it's really easy to get in touch. Just head over to and click on the Contact link.

Also, I want to remind you, the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So if you have a concern about your child's health, make sure you 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

All right, let's take a quick break, and I will be back with News Parents Can Use right after this.



Dr. Mike Patrick: One of the great things about creating a new podcast, and many of my listeners remember me talking a couple episodes back that we're going to be starting a new podcast called PediaCast CME, which instead of being aimed at parents is going to be aimed at medical providers. So pediatric news for medical providers, we're going to offer Category One CME.

So that's coming your way soon, and part of the process of developing a new podcast, I wanted to get a some new bumper music. So this episode and the last one, you may have noticed some freshening of the songs that you hear in the bumpers between the intro and the outro, so enjoy. Hopefully, we'll just get a little refreshing. We'll still bring back the old stuff now and then.

All right, let's move on to the news this week. New findings from research in the Seychelles — that's a group of islands in the Indian Ocean — provide further evidence the benefits of fish consumption on pre-natal development may offset the risk associated with mercury exposure.

In fact, the new study, published in the American Journal of Clinical Nutrition, suggests that the nutrients found in fish have properties that protect the brain from the potential toxic effects of the chemical. Three decades of research in the Seychelles have consistently shown that high levels of fish consumptions by pregnant mothers — an average of 12 meals per week of fish — do not produce developmental problems in their children.

Researchers have previously equated this phenomenon to a kind of biological horse race with the developmental benefits of nutrients in the fish outpacing the possible harmful effects of mercury also found in the fish.

However, the new research indicates that this relationship is far more complex and that compounds present in the fish, specifically polyunsaturated fatty acids, may counteract the damage mercury causes in the brain.

Dr. Edwin van Wijngaarden, co-author of the study and associate professor in the University of Rochester Department of Public Health Sciences, says, "These findings show no overall association between prenatal exposure to mercury through fish consumption and neurodevelopmental outcomes. It is also becoming increasingly clear that the benefits of fish consumption may outweigh, or even mask, any potentially adverse effects of mercury."


Dr. Sean Strain, a professor of Human Nutrition at the Ulster University in Northern Ireland and lead author of the study, says, "This research provided us the opportunity to study the role of polyunsaturated fatty acids on development and their potential to augment or counteract the toxic properties of mercury. The findings indicate that the types of fatty acids a mother consumes during pregnancy may make a difference in terms of her child's future neurological development."

The new study comes as the US Food and Drug Administration and international agencies are in the process of revisiting fish consumption advisories to better reflect the health benefits of nutrients found in fish. The FDA's current guidance, which recommends that pregnant women limit their consumption of certain fish to twice a week, was established because of the known risk of high levels of mercury exposure on childhood development.

Mercury is found in the environment as a result of both natural and human activity. Much of it ends up being deposited in the world's oceans and, as a result, fish harbor the chemical in very small amounts.

Those fish that are on the upper level of the fish food chain, they tend to have more mercury in them — things like tuna, for instance. This has given rise to concerns that cumulative impact of prenatal exposure to mercury through fish consumption may have negative health outcomes, despite the fact that link between low-level exposure and developmental consequences in children has never been definitively established.


At the same time, fish are rich in a host of beneficial nutrients, including fatty acids, which are essential to brain development, leading to a long-standing conversation between scientists, environmentalists, and policymakers over the risk versus benefit of fish consumption. This debate has significant consequences for global health, as billions of people across the world rely on fish as their primary source of protein.

The Seychelles Child Development Study — a partnership between the University of Rochester Ulster University and the Republic of Seychelles Ministry of Health and Education — is one of the longest and largest population studies of its kind. The Seychelles has proven to be the ideal location to examine the potential health impact of persistent low-level mercury exposure. The nation's 89,000 residents consume fish at a rate 10 times greater than the populations of the US and Europe.

The study followed more than 1,500 mothers and their children. At 20 months after birth, the children underwent a battery of tests designed to measure their communication skills, behavior, and motor skills. The researchers also collected hair samples from the mothers at the time of their pregnancy to measure their levels of prenatal mercury exposure.

The researchers found that mercury exposure did not correlate with lower test scores. This finding was consistent with previous study results that also showed no association between fish consumption and subsequent neurological development. And some of the studies followed Seychellean children into their 20s.

The researchers also measured the polyunsaturated fatty acid levels present in the pregnant women and found that the children of mothers with higher levels of fatty acids known as n3 — the kind found in fish — performed better on certain tests. Another common form of polyunsaturated fatty acids, called n6, comes from other meats and cooking oils and is found in greater abundance in the diets of residents of developed countries.

The fatty acids in fish, the n3, are known to have anti-inflammatory properties, compared to n6, which can promote inflammation. One of the mechanisms by which mercury inflicts its damage is through oxidation and inflammation, and this has led the researchers to speculate that not only does n3 — again that's the fatty acids found in fish — provide more benefit in terms of brain development, but that these compounds may also counteract the negative effects of mercury, namely oxidation and inflammation.


This was reflected in the study's findings, which showed that the children of mothers with relatively higher levels of n6 — the non-fish kind — did poorer on tests designed to measure motor skills.

Dr. Philip Davidson, senior author of the study and principal investigator of the Seychelles Child Development Study, and a professor emeritus at the University of Rochester, says, "It appears the relationship between fish nutrients and mercury may be far more complex than previously appreciated. These findings indicate that there may be an optimal balance between the different inflammatory properties of fatty acids that promote fetal development and that these mechanisms warrant further study."

So there you go. At least, according to this population study in the Seychelles, and also some previous ones, eating fish while you are pregnant may not be such a bad thing after all. Now, does it matter what type of fish they were eating? Maybe. And I'll probably still talk to your regular doctor or OB-GYN before you start consuming large amounts of fish while you're pregnant.

You'll like how I put the responsibility on someone else. Hey, look, I'm not practicing medicine here, just reporting the news.

Napping helps infants develop their memory and retain new behaviors they have learned. This, according to a new study from the University of Sheffield.

Babies devote the majority of their time to sleeping, but until now, very little was known about the links between sleep and the unprecedented levels of growth and development that take place during the first year of life.

In a first of its kind study, researchers from the University of Sheffield and Ruhr University Bochum, Germany, found that the notion of 'sleeping like a baby' is extremely important in declarative memory consolidation, such as retaining facts, events and knowledge. Researchers explored whether daytime sleep after learning helped babies to remember new behavior. The study focused on 216 healthy 6- to 12-month-old infants and tested their ability to recall newly-learned skills.


The youngsters were shown how to remove and manipulate a mitten from a hand puppet and were given the opportunity to reproduce these actions after delays of 4 and 24 hours.

Infants who did not nap after learning were compared with a group of age-matched infants who did nap for at least 30 minutes within four hours of learning the target actions.

The study, recently published in the Proceedings of the National Academy of Sciences showed that only the infants who had napped after the learning activity remembered the target actions, while those who did not nap showed no evidence of remembering the new information and behavior. After a 24-hour delay, children in the napping group also exhibited significantly better recall compared with infants in the no-nap group.

Dr. Jane Herbert, one of the researchers involved with the project and professor with the University of Sheffield's Department of Psychology, says, "These findings are particularly interesting to both parents and educators because they suggest the optimal time for infants to learn new information is just before they have a nap. Until now, people have presumed that the best time for infants to learn is when they're wide-awake, rather than when they're tired, but our results show that activities occurring just before infants have a nap can be particularly valuable and well-remembered."

The study also suggests that allowing flexible napping schedules in response to different daily schedules could help ensure optimal learning conditions for infants. The length of the nap also seem to matter. Naps shorter than 30 minutes did not provide sufficient time for infants to consolidate their knowledge in such a way that it could be retained over the long term.

Dr. Herbert adds, "Parents receive lots of advice about what they should and shouldn't do with their baby's sleep schedule. This study however examined learning opportunities around naturally occurring naps and shows just how valuable activities like reading books with young children can be just before they go to sleep."

Previously existing research has shown the enormous benefits sleep can have on adult memory abilities. Sleep helps adults gain new insights into previously encountered problems and improves flexibility in applying existing knowledge to new tasks.


The international research group will now look at whether sleep not only enhances the quantity of infants' memory, for example how much is remembered, but also the quality of memory such as how the recollections are used.

So key points from the study: babies learn best when they're sleepy; daytime naps of 30 minutes or more helps infants retain and remember new behaviors; and bedtime stories are invaluable for a child's development.

Bottom-line for me, here's what I learned. Naps are important, for babies and grown-ups, which means I shouldn't feel guilty about taking a snooze in the middle of the day. In fact, I should try to do that more often. And if I want to remember something or figure out a new solution to a problem, I should think and learn about things right before I fall asleep. I know, I made it all about me instead of the kids, but look, we're talking about the importance of naps, and that says it all.

The amount of time children spend using screens such as television and computers on a daily basis exceeds recommended guidelines, no surprise there. This, according to research published in the open access journal BMC Public Health. These guidelines were drawn up at a time when tablets, cell phones and other mobile devices were not as present in everyday life, which suggests they need to be redrafted.

Prolonged use of screens by children is associated with adverse physical and mental health outcomes, such as increased risk of depression and anxiety in adolescent girls. Although the present study does not look directly at healthy health effects on children, it is part of a longitudinal study which will.


In 2001, the American Academy of Pediatrics published recommendations that children under the age of two should have no exposure to screens and those over the age of two should have their exposure limited to less than two hours a day. These guidelines and most follow-up studies have been based on asking children about watching TV and playing computer games without asking about other types of screen media.

To address this, researchers from the University of Western Australia surveyed 2,620 children aged 8 to 16 years from 25 primary and secondary schools in Australia. The school children were shown different screen types — and these included iPads, iPod Touches, laptops, Portable PlayStations, laptop computers and Xboxes — and they were given examples of the different types of activities that could be done with those screens, things like watch TV, use Instant Messenger, play computer games, or do school and home work.

They were then asked about how many hours they used these screens, from when they woke up until they went to bed, including before, during and after school. So what did they find? Well, 63% of the children exceeded the recommended guidelines of less than two hours. Of course, no surprise there. The most popular screen time used with all participants was television, with 90% admitting to watching TV in the last week. This was followed by laptop use in 59%, iPad or tablet use in 58%, and mobile phone use in 57%.

There was also variation of screen use within individual age groups. For example, 45% of eight-year-olds exceeded the guidelines, while a whopping 80% of 14- to 15-year-olds went over. There was also a difference in screen use between boys and girls. Dr. Stephen Houghton, lead researcher of the project, says, "As anticipated boys were more likely than girls to exceed the less-than-two-hour recommendation for playing computer games, but it was unexpected that the girls were more likely than the boys to exceed the less-than-two-hour recommendation for social networking, Web use, TV, DVD, and movies."


Although, I don't know, I have a teenage boy and a 20-year-old girl at home, and that's the prediction I would have made.

Dr. Houghton goes on to say, "Of particular interest is the rate at which girls are more likely to exceed the less-than-two-hour recommendation for social networking as they got older. Specifically, by 15 years of age girls were over 15 times more likely to exceed the less-than-two-hour recommendation compared to their 8-year-old girl counterparts, and almost 7 times more so than boys."

This study was based on self-reported use of using different types of screens, but did not investigate how this has a direct impact on the children's health. Future studies should try to address this by having more objective measurements on screen use and what impact it has on well-being.

Dr. Houghton says, "The introduction of mobile devices suggests the less-than-two-hours-per-day recommendation may no longer be tenable given the surge in social media engagement and school derived screen use. Guidelines for appropriate screen use should also take into account the extent to which screen use differs across form, activity, sex, and age."

So I think the study make some good points as the use of screens becomes more and more an integral part of daily living. The more we have to realize that kids are using them for school homework and to socially connect with friends and parents. So I do see the need to stop the over-simplification and lumping together of all screen activities.

We need better guidelines on what particular screen activities and the amount of time spent pursuing each activity, how much time is helpful and in what way, and how much time is harmful and in what way, and have that kind of information for each type of screen activity. Until we have a better understanding of those numbers, I do think we have to give a lot of weight to the opinions of moms and dads on deciding what's going on in their house. Unless, of course, the parents are on their screens all day, ignoring the kids and glued to their devices in such a way they have no idea what their kids are doing. That might be a problem.


Speaking of problems, on days they eat pizza… Here we go. This is the story I was not looking forward to covering. On days they eat pizza, children and adolescents take in significantly more calories, fat and sodium than on days they don't. In fact, pizza is the second highest source of energy in the diet of American kids, and because it is eaten so frequently, about 20% of all children and teens eat pizza on any given day. Because of that, its nutritional content should be improved, so say researchers from the University of Illinois at Chicago as published in the journal, Pediatrics.

Dr. Lisa Powell, lead author of the study, says, "Curbing pizza consumption alone isn't enough to significantly reduce the adverse dietary effects of pizza. It's a very common and convenient food, so improving the nutritional content of pizza, in addition to reducing the amount of pizza eaten, could help lessen its negative nutritional impact."

The researchers examined dietary recall data from children and teenagers between the ages of 2 and 19 who are participating in the National Health and Nutrition Examination Survey between 2003 and 2010.

They found caloric intake from pizza among children ages 2 to 11 dropped 25% between 2003 and 2010. Among adolescents who ate pizza, calories from the pizza fell, although the prevalence of pizza consumption just increased slightly for teenagers.

OK, so these are good numbers, right? Well, not so fast. On days when children ate pizza, they took in an additional 84 calories, along with 3 grams of saturated fat and a 134 milligrams of sodium, compared to days they didn't eat pizza.

The numbers were worse for teenagers, who consumed an extra 230 calories, along with 5 grams of saturated fat and 484 milligrams of sodium on pizza days. By 2009 to 2010, on days pizza was eaten, it made up 22% of total caloric intake among children and 26% of total caloric intake in adolescents.


So what does all this mean? Well, according to Dr. Powell, "Children and adolescents do not adequately compensate by eating less of other foods on days when they eat pizza." As it turns out, many children and teenagers are now eating pizza as a snack in between meals. So here's your problem. And on these days when pizza is eaten as a snack, children took in an additional 202 calories, and teenagers consume an extra 365 calories compared to days they didn't eat pizza as a snack.

Researchers also looked at where and when pizza was eaten. They found that from 2003 to 2010, calories from pizza at dinner fell, but pizza consumption at lunch and from school cafeterias did not change. Overall caloric intake was similar on days when pizza from school cafeterias was and wasn't eaten, possibly because non-pizza lunch offerings were similarly high in calories.

Pizza's contribution to excess calories was generally consistent across race, gender and income, except that it was significantly higher among African-American kids as compared to Hispanic children.

Dr. William Dietz, co-author of the study and director of director of the Sumner M. Redstone Global Center for Prevention and Wellness at the Milken Institute School of Public Health at the George Washington University, says, "Because when pizza is consumed, it increases the total daily calories that children and adolescents take in, it could be an important contributor to the obesity epidemic. Moderating pizza consumption should become another goal in our efforts to reduce obesity in US youth."

The authors also suggest that because of its prevalence and impact on diet, pizza should be addressed specifically in nutritional counseling.


So there you go, it's pizza that's making us all fat, which really stings, because as I said at the start of the program, I love pizza. My son works at a pizza shop, so he's not going to be too happy about this one either.

Practical take home points for me, don't eat pizza as a snack. Make it a meal. I can do that. And when you do make pizza a meal, go light on the calories the rest of the day. So again, no snacking with pizza and minimize other calories on pizza day. That's the balance, folks. Take it or leave it.

One more smart idea, maybe make a point of exercising a little bit longer on those pizza days. Yeah, like that's going to happen. You're full of pizza, you're probably not going to go on the elliptical. Just keeping it real, folks.

All right, evidence do suggests the up to 1% of all children in the United Kingdom have blood markers for Celiac Disease. That's an auto-immune reaction to dietary gluten from wheat, barley, and rye — and it's in pizza crust by the way.

In a bid to asses current diagnostic patterns, a British research team assessed data contained in The Health Improvement Network which is a representative United Kingdom database on anonymous primary care health records. So folks in the United Kingdom, their health records, their names and identification are stripped from them, and they go into a database for research purposes and that's called The Health Improvement Network.

So researchers identified all children from birth to the age 18, registered with general practices across the United Kingdom that contribute to The Health Improvement Network between 1993 and 2012.

Over two million children were included in the study, and among them, 1,247 had been diagnosed with Celiac Disease during the 20-year period, corresponding to about 1 new case in every 10,000 children every year. This case rate was similar across all four United Kingdom countries.

It was 53% higher among girls compared to boys. Between 1993 and 2012, the rate of diagnoses rose by 39% in boys, and it doubled at 50% higher in girls. Actually, that would be a 100% higher, if doubled, right?

While the numbers of new cases in infants and toddlers remained fairly stable, diagnoses among children older than 2 almost tripled in the span of 20 years, with the diagnostic rate for Celiac Disease between 2008 and 2012 75% higher than it was between 1993 and 1997.


When the researchers analyzed the social and economic backgrounds of children diagnosed with the Celiac disease, they found those from less well-off backgrounds were only half as likely to be diagnosed with the condition. This pattern was evident for both boys and girls, and across all ages.

Researchers say the rise in new cases among children is likely to be the result of better awareness of Celiac Disease, as well as the means to diagnose it. But this does not explain the differences in diagnoses among children from different socioeconomic backgrounds.

They add, "Based on the current evidence, the most plausible explanation for the socioeconomic gradient in the incidence of childhood Celiac disease whereby children from least deprived areas have it diagnosed more often than those from the most deprived areas is the ascertainment of disease varies." So in other words, in the less deprived areas, it's thought of and searched as a diagnosis. It's ascertained more often, rather than really a true occurrence of Celiac Disease, being higher in the higher socioeconomic levels.

So, doctors, be sure to think about it, and test for it, especially if you take care of kiddos with lower socioeconomic backgrounds. Moms and dads, be sure to ask about it. And maybe that's it. Maybe in the higher socioeconomic background, maybe moms and dads are doing more research and so, they bring up to the doctor, "Hey, could this be Celiac Disease?" And that's happening less often in families with lower socioeconomic background.


Again, that's just my own thoughts on that. The important thing here though, doctors, again, be sure to think about it and test for it. Moms and dads, be sure to ask about it. It's really important. You want to get the right diagnosis and the right treatment when Celiac Disease is a concern.

So, what are the symptoms of Celiac Disease, when would you think about it? Those are great questions and I have an equally great resource for you. PediaCast Episode 274, we cover all things Celiac with Dr. Ivor Hill, a world renown expert on Celiac Disease. So be sure to check that one out, PediaCast 274, and you'll find it in the archive over at

All right, that does wrap up our News Parents Can Use this week. We still have carbon monoxide poisoning coming your way. We'll talk about that right after the break.


Dr. Mike Patrick: So some people may ask, why do you even do these bumpers? Why break up the program in that way? Well, first, sometimes I need a sip of water. By the time we do a whole round of new stories, by the end of it there, man, I can't wait to grab that glass. So that's one reason. And, I just like the music. So that's another reason, and hopefully, you do too.

All right, The Central Ohio Poison Center at Nationwide Children's Hospital cautions that the symptoms of carbon monoxide poisoning can resemble the flu. Because of the increased number of flu cases nationally this year, there is concern that those who have been exposed to carbon monoxide in invisible, odorless and non-irritating gas may mistake their ailments and symptoms for the flu.


Mild signs and symptoms of carbon monoxide poisoning that can appear to be the flu includes vomiting, dizziness, headache and confusion. More serious symptoms such as loss of consciousness are common, and loss of life or permanent disability can also occur. If there is a suspicion of carbon monoxide poisoning, leave the site of exposure immediately and call your local poison center. That number, if you're in the United States, pretty easy to remember, 1-800-222-1222.
Potential sources of carbon monoxide exposure include gasoline-powered equipment such as generators, snow blowers and water pumps, gas ranges, kerosene heaters and cooking devices such as charcoal grills and camping stoves. Other sources in the home may include water heaters, furnaces, wood stoves, fire places and even laundry dryers. 
Small fuel-powered engines are a significant source of carbon monoxide. Items powered by these engines should never be used inside a home. If an emergency generator or fuel-powered water pump is needed, it should be placed outside and far enough away from a house to allow exhaust to dissipate. Snow blowers should never be left running unattended or allowed to run while the operator is standing in or near a garage.
Heating a home with a gas range or kerosene, propane or butane space heater should not be attempted. Carbon monoxide production from these appliances varies greatly depending on the general maintenance of the device and the fuel used. These heaters can be dangerous when used in an emergent setting without proper maintenance.
Normal cooking with a gas range is unlikely to be dangerous, however attempting to cook using a charcoal grill or camping stove inside the home will produce large amounts of carbon monoxide.
Without a carbon monoxide detector, it may be impossible to tell whether the deadly gas is present. Every home should have one or more working carbon monoxide detectors, and the best ones use battery backup for times when normal electric power is interrupted. You'll also want one with digital peak concentration readout. Carbon monoxide detectors with these features are readily available and can be purchased at most hardware stores.


So a take-home points, carbon monoxide can kill you and your children; you need one or more carbon monoxide detectors in your home, especially if you use any type of combustible appliance including gas furnaces, stoves and laundry dryers, also fireplaces and gas-powered heaters. If you're worried about carbon monoxide poisoning, get out of the house and call your local poison center. And again, that number anywhere in the United Sates is 1-800-222-1222.

And that's my final word.

I want to thank all of you for taking time out of your day to make PediaCast a part of it. I really appreciate that. Don't forget to check out Make Safe Happen at, and there's also an app for iPhone and Android.

That's does wrap up our time together. PediaCast is a production of Nationwide Children's Hospital.

Don't forget, PediaCast and our single-topic, short-format program, PediaBytes, B-Y-T-E-S, are both available on iHeartRadio, which you'll find on the Web at and the iHeart radio app for mobile devices.

Our show archive, which includes over 300 programs, as well as our Show Notes, transcripts, terms of use, and contact page are available at the landing site, which is

We're also on iTunes, under the Kids and Family Section of their podcast directory. You'll also find PediaCast on Stitcher, TuneIn, Downcast, iCatcher, Pod Bay and most other podcasting apps for iPhone and Android.

We're also on Facebook, Twitter, Google+, and Pinterest. We really appreciate you connecting with us there and sharing, retweeting, and re-pinning all of our posts so you can help spread the world about the show.

In particular, Facebook is really the site where we have a little bit more of a conversation than those other place. We do announce the show and let you know about the current topics on Twitter, Google+, and Pinterest, but Facebook is really the place that we interact with one another as a community of listeners.


We also appreciate you talking us up with your family friends, neighbors and co-workers, anyone with kids or anyone who takes care of children. As always, be sure to tell your child's doctor about the program. Posters are available under the Resources tab at

Until next time, this is Dr. Mike, saying stay safe, stay healthy and stay involved with your kids. So long, everybody.


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

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