Potty Training, Breast Feeding, and Cold Mediaction – PediaCast 027
- Changes in the immunization schedule
- Infant deaths associated with cough and cold medication
- Growth and feeding in a 10 month-old
- Potty training
- Allergy to cold air!
- Breast and bottle feeding
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Announcer 2: Hello moms, dads, grandmas, grandpas, aunts, uncles, and anyone else who looks after kids. Welcome to this week’s episode of PediaCast, a pediatric podcast for parents. And now, direct from Birdhouse Studios, here’s your host, Dr. Mike Patrick, Jr.!
Dr. Mike Patrick: Hello, everyone and welcome to PediaCast, a pediatric podcast for parents. This is Dr. Mike coming to you from Birdhouse Studio and I'd like to welcome everyone to the program.
A special shout out to all the new listeners out there. You found the best digital source of news parents can use, answers to your questions about child health issues, and the latest round up of current researched topics in the world or pediatric medicine. If you're new and listening at the website, be sure to subscribe to our feed by adding us to iTunes or any other podcatcher, that way you won't miss a single episode. And, of course, a warm welcome back to my loyal listeners. You folks are the ones who keep PediaCast alive and kicking. If you like to bring more life to the program, be sure to tell your friends, relatives, co-workers, and neighbors about the show. Reviews in iTunes works wonders as do diggs of each episode in the podcast section of digg.com, that's "digg" with two "Gs". We have full show lined up for you today. Here's a rundown of the topics. In the news, parents can use segment or report on updates to the immunization schedule and infant deaths associated with cough and cold medication then more answer to listener's questions regarding feeding and growth in a ten-month old infant and allergic reactions to cold air.
Yes, you heard me right.
We're talking severe hives brought on by cold exposure. Finally, we'll wrap up the show with our research round up. This week's topic, a unique approach for head lice treatment and a review of the Sudden Infant Death Syndrome. Don't forget, if you like to join the conversation and want to contribute something to our listener's segment, it's an easy thing to do. Simply swing by the website at pediacast.org and click on the contact link. If you'd rather send an email, you can do that by writing to firstname.lastname@example.org. And if you want to leave a voice message, simply attach an audio file to your email or call the Skype line at (347) 404-KIDS, that's (347) 404-K-I-D-S. Now, returning listeners will notice a new format this week and it's what I hope to stick with. You know, we've answered lots of listener's questions in recent episodes and I've appreciated all the fantastic listener participation. This week, we continue answering questions from moms and dads, but back by popular demand, I'll be adding news and research segments back to the program.
Honestly, I've also missed those parts of the show, so it will be nice to get them back in the line up. All right. Before we get started, I do want to mention, you have to excuse my voice just a little bit. One of the bad things about being a pediatrician in this time of the year is I'm exposed –
– you know, like to a different virus about every, what, 10, 15 minutes or so. So, I've had a big viral load and boy, it's gotten me down. I – last Monday, when we came out with the show, I did say, "I really wanted to try to get another one out by the end of the week" and obviously that didn't happen and a lot of it just has to do with this nasty cold that I'm trying to fight off right now. But I couldn't hold back any longer, so you just have to excuse my voice and we'll move on with things. OK. Well, before we get started, let me remind you that the information presented in PediaCast is for educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.
– return with news parents can use right after this.
First up in our news parents can use segment, immunization schedule changes. This comes from the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services. Children and the adolescents can now be protected against more diseases than ever before according to the 2007 Childhood and Adolescent Immunization Schedules released jointly by the Centers for Disease Control and Prevention, The American Academy of Pediatrics, and The American Academy of Family Physicians.
The 2007 schedule include new immunization recommendations for a rotavirus, human papillomavirus or HPV, varicella, also know as chickenpox, and childhood influenza. For the first time, the recommended childhood and adolescent immunization schedule will be divided into two schedules. One, for children from birth to 6 years of age and a second, for those 7 to 18 years of age. "This change reflects the growing importance of insuring timely adolescent vaccination. These new schedules reflect the great strides we're making to protect children and adolescents against serious diseases including cancer", said Dr. Anne Schuchat, Director of the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases.
We are providing a separate schedule for those 7 to 18 years of age because of an increasing number of vaccines being developed to protect the adolescents against disease. The 2007 childhood immunization schedule includes new recommendations for oral rotavirus vaccine, varicella vaccine, and influenza vaccination. Infants are now recommended to receive three doses of oral rotavirus vaccine at two, four, and six months of age. Rotavirus is a disease that causes severe diarrhea in babies and young children. It is responsible for more than 200,000 emergency room visits, 55,000 to 70,000 hospitalizations, and 20 to 60 deaths each year in the United States. Children four years to six years of age are now recommended to receive a second dose of varicella or chickenpox vaccine to further protect against the disease.
About 15% to 20% of children who received only one those of varicella vaccine are not fully protected against chickenpox. The first dose is recommended at 12 to 15 months of age. Older children, adolescents, and adults should also receive a catch-up second dose if they previously had received only one dose. Before the licensure of varicella vaccine, there were, on average, about 13,500 hospitalizations and 150 deaths from complications of varicella or chickenpox each year in the United States. The childhood influenza vaccination recommendation has expanded to include children 24 months to 5 years old as well as their household contacts and caregivers. The previous recommendation was for children six months through two years. Now, children from six months through five years are recommended for annual influenza vaccination. This recommendation was expanded because influenza often causes serious illness in children two to five years old.
The number of emergency room and healthcare provider visits related to influenza is higher for two to five-year olds than for healthy older children. Children 6 to 24 months of age are nearly as likely to be hospitalized for complications from influenza as adults, 65 and older. The 2007 recommended immunization schedule for children and adolescents also recommended that girls ages 11 to 12 years of age receive a three dose series of human papillomavirus or HPV vaccine with the second dose two months after the first dose and the third dose, at least four months after the second dose. The recommendation also allows for vaccination of girls beginning at nine years old as well as vaccination of girls and women 13 to 26 years old. HPV is the leading cause of cervical cancer in women. More than 20 million men and women in the United States are currently infected with HPV and there are 6.2 million new infections each year.
So, the bottom line with this report – you know, it's particularly important that you not skip any well check appointments this year because nearly every child in the United States right now is due for some immunization or another. All school age and teenage kids need that second chickenpox unless they have a history of a significant natural chickenpox infection. Another immunization not mentioned in this report is the hepatitis A vaccine. It's another new one added to the current immunization schedule published by the American Academy of Pediatrics and it's recommended for all children ages 12 months through 18 years. So, again, this year it's particularly important that all children see their doctor for well checkup appointments to get caught up with these latest vaccine recommendations. All right. Our second news item of this week, infant deaths associated with cough and cold medications. This comes from the January twelfth edition of Morbidity and Mortality Weekly Report.
Cough and cold medications that contain nasal decongestants, antihistamines, cough suppressants, and expectorants commonly are used alone or in combination in attempts to temporarily relieve symptoms of upper respiratory tract infection in children aged less than two years. However, during 2004 and 2005, an estimated 1,519 children aged less than two years were treated in U.S. Emergency Departments for adverse events including overdoses associated with cough and cold medications. In response to reports of infant deaths, after such events, CDC and the National Association of Medical Examiners or NAME investigated deaths in the U.S. of infants aged less than twelve months associated with cough and cold medications. This report describes the results of that investigation which identified deaths of three infants aged less than six months in 2005 for which cough and cold medications were determined by medical examiners or coroners to be the underlying cause.
The dosages at which cough and cold medication can cause illness or death in children aged less than two years are not known. Food and Drug Administration or FDA approved dosing recommendations for clinicians prescribing cough and cold medicines do not exist for this age group. Because of the risk for toxicity, absence of dosing recommendations and limited published evidence of effectiveness of these medications in children aged less than two years, parents and other caregivers should not administer cough and cold medications to children in this age group without first consulting healthcare providers and should follow the provider's instructions precisely. Clinicians should use caution when prescribing cough and cold medication to children aged less than two years; moreover, should also always ask caregivers about their use of over the counter combination medications to avoid overdosing children for multiple medications that contain the same ingredient.
In January, 2006, NAME, just the National Association of Medical Examiners in collaboration with the CDC initiated an email inquiry requesting reports of deaths in infants aged less than 12 months for which cough and cold medications were determined as the underlying cause. To identify additional cases, CDC examined media and medical journal reports of infant deaths suspected to be linked to cough and cold medications during 2005. A total of 15 local medical examiners and 12 U.S. States and Canada responded to NAME's survey. However, no cases other than those from media and published reports were identified. From these reports, CDC identified three cases of infant deaths in two states during 2005 that were determined by a medical examiner or coroner to have them caused by cough and cold medications. The three infants ranged in age from one to six years, two were male.
All three infants had what appeared to be high levels of pseudoephedrine and nasal decongestant in postmortem blood samples. The blood level of pseudoephedrine ranged from 4,743 nanograms per milliliter to 7,100 nanograms per milliliter. One infant had received both the prescription and an over the counter cough and cold combination medicine at the same time, both medications contains pseudoephedrine. The two other infants also had received pseudoephedrine containing medications, one prescription and one over the counter. Two of the infants had been administered prescription medications containing carbinoxamine which is an antihistamine, although neither had detectable postmortem blood levels of carbinoxamine. Two of the infants had detectable blood levels of dextromethorphan, a cough suppressant also commonly called DM, and acetaminophen, which is what's in Tylenol which is a fever reducer and a pain reliever.
All three infants were found dead in their homes. Autopsy and medical investigation records were obtained. A medical examiner or coroner determined that cough and cold medication was the underlying cause of death for each of the three. None of the deaths were determined to be intentional. On autopsy, two of the infants had evidence of respiratory infection. No abnormalities in cardiac pathology were revealed in any of the infants. So, the bottom line with this story is that all of us, doctors and parents, should think twice about prescribing and giving cough and cold medications to children who are less than two years of age. However, you know, you got to look at the perspective here. We're talking three babies in one year and how many babies, you know, got a better night sleep because of the cough and cold medicine. It's, you know, hard to know and it becomes difficult to, you know, make these decisions. Certainly, I have parents, all the time, of infants want to know what they can do to help relieve the cough and cold and the – or the cough associated with the cold and the runny nose and –
– you know, it becomes difficult to say, "Hey, you know, you're not supposed to be doing this anymore." It probably doesn't really help their runny nose or the cough all that much. What it does do is help them sleep which, you know, parents sometimes need when –
– their kids to sleep when their sick. So, it just means you got to look at the – you got to look all of it and understand that there's risk in just about everything that we do. OK. That wraps up today's news parents can use. We'll be back with our listener's segment right after this.
Sarah: Hi! My name is Sarah. I'm from Mason, Ohio. And I just got a question about my daughter who is almost two months old. She just does not – want to eat solid food at all. Usually, we'll be able to get a couple of bites out of her. Sometimes a miracle happens and show empty jar but that's only happened a handful of times. We tried to do varied things. We tried to change the way we do feeding time, how we feed her. We tried to stay positive and make it fun and not a lot of pressure. When she's done, she's done. But my only concern is that her annual appointment, she was only in, like, the twentieth percentile for height and weight. Our pediatrician didn't seem like he was too concerned; although, he did mention if this trend continues, because she did take a little bit of a dive on the chart, on the twelve month, he would like to do growth hormones and thyroid assessment. We'd really like to avoid that. And genetically, my husband and I aren't physically huge people and our family certainly is small as well.
So, I'm just wondering if you had any suggestions. She is – we're trying to do some more finger foods, something little, bits of banana and things like that. If you have any suggestions for other foods we may be able to try – she doesn't want feed herself but just play with it. But if you feed her, sometimes she'd take it. So, thanks so much for your help. I find your podcast so informative and a great way to help a first-time mom like me. Thanks again. All right. Bye-bye.
Dr. Mike Patrick: All right. Thanks for your question, Sarah. So, as I understand it, you have a ten-month old infant who is at the twentieth percentile for height and weight but recently did take a dive. So, I'm assuming that before they were at the, you know, closer to the fiftieth percentile and now we're down at around the twentieth. She's a skimpy eater and has a family history of small people and the pediatrician's concerned and – suggested getting blood work at the twelve month visit. But you are as concerned –
– and you just want to know how you can get her to grow a little bit more so that you can avoid more of a work up. Well, it sounds to me like your daughter is sort of settling into her place on the chart and I guess, my degree of concern really depends on how much of a dive she took. It will be interesting to see where she is on the chart at twelve months. If she takes another big dive – you know, so now she's down with the fifth or tenth percentile, then I wouldn't be concerned a little bit about that. And many pediatricians get blood work at twelve months anyway. They'll check on anemia or check on the lead levels. So, if you really – you're not putting her through anything more, you know, they have a thyroid test or growth hormone. He may also consider a sweat chloride test to look for cystic fibrosis. But, you know, having said that, I agree with the assessment that things are probably fine. You know, genetics play a large role in growth so if you're daughter is following the family pattern, I'm definitely less concerned. You know, with regard to her being a skimpy eater, keep in mind, one of the ways that our bodies control our growth is by our appetite and the amount of calories that go in.
You know, grandmas will say, "Kids who aren't growing well because they're just not eating enough and that's the reason that they're not growing well". But the truth is most kids who don't eat – you know, they have slim appetites because genetically, they're programmed to be small. So, it's not a problem with their not eating enough and that's why they're so small. It's that they're programmed to be small and that's why they don't have as much of an appetite as you might otherwise expect. Now, twentieth percentile in both height and weight is absolutely fine. I mean, that's normal. That means that out of – you take a hundred kids still – just at random who are all the same age and same sex, that means that 20 of them are going to be smaller than your child is. So, twentieth percentile, there's absolutely nothing wrong with that at all. It's really more of the big dive and that's what makes you upset a little bit, especially if that trend were to continue with dropping percentiles.
It's reassuring that the length and weight are mirroring one another. You do worry more if there's a big weight drop in percentile and length is staying about the same. I should also point that many kids follow a stair step pattern on their growth chart. And for these kids, that's perfectly normal. So, they'll basically have flat growth and sort of dropped percentiles and then a rise back to the percentile they were before and then flat growth and then arise and then flat growth and then arise. So, rather than a smooth curve going up, it's really more – their growth chart looks more like a set of stairs. With regard to eating, I don't think I would change anything that you're doing until the twelve month visit. If weight and height take another dive at that point, you know, then I might go through some extra testing just to be sure. But again, I've – your child is probably going to need some blood work around twelve months anyway so you're not really putting her through anything more; just, you know, spending more money.
I – you know, I think it's fine to make an effort to increase calories at that point. You know, if at twelve months she's taking more a dive and you're getting concerned, that's when I would start to think about increasing calories, but I think I would just probably stay at – you know, just keep doing what you're doing and just see where you are at the twelve month visit. You know, my wife and I went through a similar time with our daughter, who's now 12, and like you, Sarah, our families are small and my daughter was actually just below the third percentile when she was a year old. And we did the extra blood work and checked for cystic fibrosis and everything turned out fine. At twelve months, we begin giving her a mixture of half whole milk and half – half and a half dairy cream to bump up the calories, that was the recommendation from the nutritionist that we saw. And we also made Pediasure pancakes and buttered everything like crazy just to try –
– to get more calories in. And she gained a little bit more weight but not that much. I mean, she stayed just below the third percentile, just – she was ten or so. In the last couple of years, she has began to sprout and is definitely on her way to catching up with the – well, at least with the smaller 12-year olds.
In terms of a magical way to get your daughter to eat more solid foods, I really don't have a good answer for that. I mean, if she's getting over 25 to 30 ounces of fluid in a day, you could try backing off on that to see if her solid intake will increase a little bit. You can also try offering the solids before the bottle or sippy cup, but I bet you're doing that already. You know, in the end, I wouldn't get too crazy with changing your feeding methods based on what you've told me. I'd sort of just go with the flow until the twelve month visit and then reevaluate and see where you are at that point. So, I hope that helps, Sarah and thanks again for writing in. OK. Moving along in the listener's segment. Here's a segment – here's a quick note from Jessica in North Carolina. She says, "Dr. Mike, my son and only child, Ryan, is 2 1/2. He's a healthy and normally developing little boy. He has met or surpassed all his milestones but potty training is another story.
He has no desire to even try. I am not too concerned as I have read not to push the issue; however, one of his daycare teachers is really putting him under pressure and I am not sure what to do." Well, thanks for the question, Jessica. You know, it's not all that uncommon at all to have a two-year old who just isn't potty-trained yet, especially for boys. And even though the rest of the milestones are coming along from a physical standpoint, he may simply not have the muscular control required for a potty training. Now, way back in episode number four –
– of PediaCast, we talked in great detail about potty training. So, I'm going to refer you back to that show. There'll be a link to episode four in the Show Notes this week so it should be pretty easy for you to find. Also, I increased the number of programs in the feed and all them are there now, going clear back to show number one. So, you should be able to find show number four pretty easily in the feed or you can go to the website at pediacast.org and just click on today's Show Notes and there'll be a link back to episode four.
And you'll have to forgive – you know, there's a learning curve with this podcast. So, you have to forgive me if episode four didn't sound quite as good, not that this one sounds very good with my cold, but you know what I'm saying. All right. Let's take a short break and I'll be back with more from our listeners right after this.
Terry: Hi! This is Terry in Kansas. And I just wanted to say that I really – and I have 11-year old foster child as well as – they're brothers.
And I've come across something that I've never seen before. My 11-year old is allergic to cold air and he will break out in hives and – he does take loratadine but – or something like that. I'm not if I have the pronunciation correct. But I'm just wondering if this is something that is common. Is it rare? It's nothing I've heard of before. Anyway, thanks for the great show. Talk to you later. Bye.
Dr. Mike Patrick: Well, thanks for your question, Terry. So, your 11-year old foster child has a cold air allergy. Well, you're right.
It's not very common, but it's not unheard of either. And I've seen a few kids with a cold urticaria. By the way, that's a fancy way of just saying hives caused by the cold. And it's not just cold air that can do it, cold water can have an effect as well. Basically, it happens like this, there's a type of cell in the body known as a mast cell, M-A-S-T, mast cell.
And inside the mast cells are chemical called histamines. And for kids who have this problem, the trigger, in this case, cold air or water, triggers the mast cells in that region to release a load of histamines which in turn causes the hives. Now, the medication that you mentioned Loratadine, which is the active ingredient in over the counter Claritin and all the generic off brands of Claritin, that is an antihistamine. It bonds to the histamine receptors on your cells so that the histamines from the mast cells can't bond. And if the histamines can't bind to the receptors on other cells then the hives don't result. So, Zyrtec and Allegra are other good medications to prevent cold related hives, but they're still only available by prescription and they're a lot more expensive than generic, over the counter Loratadine is. But for some, the Claritin doesn't seem to help or the Loratadine doesn't and the Zyrtec and Allegra do. So, there are other options if the over the counter Loratadine or Claritin is not helping out.
Now, once a person with cold urticaria breaks out in hives, Claritin or Loratadine or Zyrtec, Allegra, any of those, probably won't help much. You know, they are relatively weak antihistamines and they're better suited for prevention than for actual treatment. Now, Benadryl, and the generic name for Benadryl is diphenhydramine, it's a much stronger antihistamine and that will help chase the hives away once they appear. A word of caution about Benadryl though, it does make you pretty sleepy. Now, it's very, very rare but sometimes cold urticaria becomes very severe with difficulty breathing, wheezing, and possibly even a drop in blood pressure. This is called anaphylaxis and it's very serious and can lead to death. And because of that, it's a good idea for people with cold urticaria to have an injectable EpiPen available in case of a severe anaphylactic reaction. It's basically epinephrine in a little pen that you just put up against the thigh and the needle goes in and it auto-injects.
And you can ask your doctor to get you a prescription for an EpiPen. And they're even available for very young children too. Now, again, you'd only use that if it was a severe anaphylactic reaction. So, they were wheezing, having trouble breathing, you know, basically they're going to die if you don't do something. And I'm not saying this, Terry, to scare you because it's a – again, it's extremely rare. But, you know, it's like the boy scouts, be prepared. There is no cure for cold urticaria, just avoidance of cold air and water and a preventative antihistamine just like you're doing. But the good news is that as time goes by, the reactions often become less frequent and less severe and within five or six years, they often disappear altogether. A cold urticaria can happen at any age, but it's most commonly seen in young adults between 18 and 25 years of age. Wikipedia has a really nice summary of the condition. And I'll put a link in the Show Notes so you could head on over and take a look at that.
OK. Before we move on to our research round up, I have a quick comment from Erin in Massachusetts, and this is Erin from Manic Mommies. Erin says, "Hi, Dr. Mike. Perusal, I'm really enjoying your show. This week's episode was great. I wanted to talk to the woman who wrote in about her baby suddenly not taking a bottle at four months old, that happened with my first baby and it was right around the time I returned to work. Of course, I got incredibly worried. After – work for me, was having someone else give baby the bottle. I even left the house entirely so baby could not see, hear, or even smell me. Also, I found that when I gave the bottle, turning baby out and away from me for the bottle, sending him up against me instead of putting baby in the nursing position for the bottle feeding also helped. Just a tip I'd pass along to add to your awesome advice. Keep up the good work. Erin." So, Erin from Manic Mommies, which is a great program – if you haven't checked that out, be sure to go to manicmommies.com, research for Manic Mommies in iTunes.
My regular listeners will know how much I love their program. Well –
– except when it gets in trouble for not doing enough around the house, but overall, it's a great, great program. Erin brings up a fantastic point that I did not mention in last week's program. In fact, after my wife listened to the show, it was the first thing she brought up as well. So, if you're having trouble getting your baby to take a bottle, rather than breastfeed, you should try to make yourself scarce during those feedings if you can because the sight, sound, or smell of mom would definitely hinder your efforts. So, that is an important point to keep in mind. And thanks Erin for bringing that up. And thanks to Karen took, my wife, because she brought it up as well. All right. That wraps up today's listener's segment and we'll return with the research round up right after this.
OK. Welcome back to PediaCast. It's time for our research round up. Today, we're – we have two research studies we're going to talk about very quickly. The first one, the title is "An Effective Nonchemical Treatment of Head Lice" and this comes from the November 2006 edition of the journal Pediatrics. The study itself is out of the University of Utah in Salt Lake City. Now, it's been known for half a century that body lice die when they're exposed to 51 degree Celsius air for five minutes and that the nits or eggs die if they're exposed to 55 degree Celsius for 90 seconds.
So, the purpose of this study was to see if hot air would also be an effective treatment for head lice infestation. So, we know that hot air kills body lice, but will it kill and be an effective treatment for head lice. So, what did they do? Well, they basically came up with six different treatment methods that you could use to get hot air onto the head lice, the live lice and the nits. And they tried these six different methods on a total of 169 individuals with known head lice infestation. The first type was a Bonnet style hair dryer. Well, that must have been interesting. I guess, you know, the kind that – like at a beauty salon. Number two was a handheld blowdryer with a diffused heating. So, they just kind of, you know, move like your – like your drying your hair basically. Number three was a handheld blowdryer with directed heating. So, here, the heating was a little closer to the head right at the areas where most of the nits where or the live lice were seen.
The fourth was just a wall mounted dryer, you know, think public restroom. And now, this is where it gets interesting. The fifth kind was the "LouseBuster" –
– which is a custom-built high volume blower that delivers hot air at a relatively constant temperature. And then number six, the method was the LouseBuster again, this time with a hand piece. And the hand piece is a custom designed molded plastic apparatus with coarse teeth that is pulled to the hair like a rake. Now, each of these methods were used for 30 minutes and the subjects had no chemical treatments for the lice. That was – all they did was this heat for 30 minutes. And then they were reexamined for living lice and egg viability immediately after the treatment and then they were reexamined one week later to see if they had a lice infestation.
OK. Let's go down to the result and move on because I'm already starting to get a little itchy just talking –
– about this. Basically, all six methods did a good job of killing the nits or the eggs and they had greater than an 88% success rate. The living lice were killed best with the LouseBuster and that had an 80% success rate at killing the live lice. And then the other methods were less than 80%. Now, virtually, all of those treated with the LouseBuster though had no living lice and no viable nits or eggs that one week post treatment. Also, treatment was well tolerated and there were no adverse effects. So, the conclusion of this study was that hot air exposure for 30 minutes, especially when done with the LouseBuster –
– is a good alternative to chemical treatment of head lice infestations. And incidentally, the LouseBuster is produced by Dexterity Design in Salt Lake City. And it's not yet produced for the consumer retail market, but it's supposed to be coming soon and I'm going to bet that it's going to do well.
I'm not sure what the price will be, but it sounds like something every school nurse should have –
– at their disposal. And I'll put a link in the Show Notes that has more information and a picture of the LouseBuster so you can see what this thing looks like. And you can say, "Hey, I heard about it first on PediaCast." An interesting side note, and I love this part, at the end of the research article, one of the authors added this, "Finally, Mr. Atkin apologizes to his wife again for accidentally giving her head lice."
I'm not kidding. That's really in the scientific journal article. Oh, brother. And moving on in our research segment, to our second study. This is SIDS Risk Factors and Factor Associated with Prone Sleeping in Sweden, remember SIDS is the sudden infant death syndrome. And this comes from the October 2006 edition of the journal Archives of Diseases in Children.
It's a study that was done in Gothenburg University in Gothenburg, Sweden. Basically, the incidents of sudden infant death syndrome increased in most western countries in the 1980s. And around that time evidence began to mount suggesting that prone or belly sleeping was a risk factor for SIDS. And another identified risk factor for SIDS was maternal smoking. So, if mom smoked, there was more a chance of a SIDS death. Now, during the 1990s most western countries, including Sweden, embarked on campaigns to educate parents about this links. So, parent were counseled to put their babies to bed in a supine position or on their back and they were also counseled not to smoke around their infants. And the study was simply to see if parents listened to this advice over time. So, what they did is, it's a population based case control study.
So, that means that each group in the study are going to try to get them matched as closely as they can in terms of socioeconomic levels, ages of the kids, you know, background. They'd really try to get these kids to be pretty identical in the two groups with the only difference being the time period in which these kids were born. So, they looked at 5,600 healthy six-month old infants who were born in 2003 and compared them with the group of infants born between 1991 and 1995 who had, you know, similar other things about them, you know. So, they basically came from the same kind of place. They – only difference is that some were born in the early 90s and some were born in 2003 and they're going to compare the two groups. Well, the results were that prone sleeping or sleeping on the belly decreased from 31.8% in the early 90s to 5.6% in 2003, so it went from 31.8% to 5.6%.
And maternal smoking decreased from 23.5% in the early 90s to 9.5% in 2003. So, the conclusion of the study was that it appears that education campaigns are effective in changing mom and dad's behaviors. Also, you know, since there was a dramatic decline in the incidents of SIDS death when you compare the early 90s to recent years, it appears that having parents heed that advice made the difference. So, this just goes to show, you know, not all studies have to be fancy and complicated. You know, this is a simple survey that shows educational efforts do pay off. And since parental education is the goal of PediaCast, I thought this study would be a nice one to include. See, you taking the time out of your day to listen to this podcast might pay off for you sometime. Well, that's my hope anyway. All right. That concludes today's research round up and I'll be back with the final word right after this.
All right. I want to take the time to thank all of my new and returning listeners out there for making a little time in your day for PediaCast. Thanks also go out to my family for supporting this crazy project. And of course, thanks also to Vlad over at vladstudio.com for contributing the artwork for – at the website and the one – the artwork that we use on our sound files as well. You can find free custom wallpaper and easily affordable high definition prints at his website. Again, you can find his work at vladstudio.com, that's V-L-A-D, studio.com.
Don't forget that if you have a question or comment for the listener's segment, simply browse over to pediacast.org and click on the contact link. You can also email me by writing to email@example.com. And if you want to send a voice message, you can attach the audio file to your email or call the Skype line at (347) 404-KIDS, that's (347) 404-K-I-D-S. Reviews in iTunes are really important for the continued success of this show. And iTunes – anyone who made a comment and they were anonymous, those comments were taken off at the iTunes store. So, they want to get rid of all the anonymous comments. So, if you didn't sign in the iTunes and did a review of PediaCast, those reviews are all gone. So, we lost quite a few reviews in that process. So, if you haven't done a review in iTunes, please do that because it really makes a big difference in terms of how you're ranked on their site.
Also, another important place is digg.com, that's digg with two "Gs". They have a podcast section. If you do a search for PediaCast, make sure that you digg our episodes and you can digg each episode individually and the more diggs you get, the higher you go in the podcast rankings. And we want to get up as high as we can so that we can let more parents know about this resource that's available to them through PediaCast. So, please go to digg.com, digg with two "Gs", and digg us. I am going to also try here soon to get a link to digg with each of the Show Notes so that you can find the shows that you like and just click on them and that will automatically digg the show for you. So, we'll work on that. Also be sure to leave reviews at Podcast Pickle and Podcast Alley. Promotional materials are available for download on the poster page at pediacast.org.
And I did get an email recently from someone, I think in Texas, who downloaded the posters and gave them to their pediatrician and their pediatrician like the program and hung the posters up in their examination room somewhere in Texas, so that's fantastic. You know, if you go to a certain nursery or a community center, you know, be sure to get one of those posters from the poster page and hang it up so we can let more people know about PediaCast that way too. And of course, be sure to tell your friends, family, coworkers, and neighbors about the show so we can empower more parents to understand and make great decisions regarding the health and well-being of their children. So, until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So, long everybody!
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