Second-Hand Smoke, Baby Crib Recall – PediaCast 053

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Announcer 1: This is PediaCast.

Welcome to PediaCast, a pediatric podcast for parents, The News Edition. And now direct from Birdhouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone and welcome to Pediacast. It is Episode 53 for Monday, September 24th, 2007, "Baby cribs, FluMist, and Noise."

And of course, before we get started though, I didn't tell you, this last weekend, we went to Sonic. Now we have a new Sonic that is just right down the street from our house. I mean, just built within probably last month to six weeks or so, and it's kind of a novelty. We've had them down and around the Cincinnati area and when we traveled south like down to Florida, we've gone to them down there before. But it's sort of neat to have one near our house because even in the Columbus area, there aren't very many of them. We live about 20 minutes from the center of the city, maybe closer to half an hour. So to get a Sonic right around the corner from where we live is a pretty big deal.

So we went there. And I just want to say one thing, Sonic Burger — like hamburger and cheeseburger — smell in a closed up car. It smells for a couple of days or so.


Dr. Mike Patrick: We love the rest of the menu. I just might avoid the burgers next time. The cream slushes are particularly good and the girls in roller skates bringing your food out to your car, that's a nice touch. Reminds me of the old root beer stands from when I was a kid. So anyway, it's kind of fun. So that's Sonic. No, they're not a sponsor. Just, we had a good time there and I wanted to share with all of you.


All right, don't forget if there is a particular piece of information that you would like to provide to us, whether that be a news story or a topic that you would like us to discuss. It's easy to get a hold of us. Just go to and click on the Contact link or email You can also call the Skype line at 347-404-KIDS, 347-404-K-I-D-S, and leave your comment that way if you would like.

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And with that in mind, we'll be back with News Parents Can Use right after the short break.


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


Teens exposed to secondhand smoke at home are at an increased risk of test failure in school, suggest a new study in the Journal of Adolescent Health. A retrospective study suggests that in adolescents, secondhand smoke exposure could interfere with academic test performance, said lead author Bradley Collins, Ph.D and assistant professor of Public Health and director of the Health Behavior Research Clinic at Temple University. Taking other known risk factors into account, for examples, socioeconomic status, gender, prenatal exposure to smoking and active smoking during adolescents, Collins and his colleagues found that exposure to secondhand smoke at home decrease the odds of passing standardized achievement test by 30% in 16 and 18 year-olds. Surprisingly, the study found that when examining the effects of prenatal tobacco exposure and secondhand smoke together, prenatal exposure did not influence test performance.

According to the researchers this study results bolster growing evidence of the academic effect of secondhand smoke and should further encourage efforts to reduce this environmental threat. "It's important that we help smoking parents learn how to reduce their children's exposure to secondhand smoke, a goal that can be achieved without requiring the parent to immediately quit smoking. Although, that's the ultimate goal for the health of the entire family," said Collins.

Current smoking cessation success rates are low, ranging from 20% to 28% in the United States. The researchers who analyzed data from 6,380 pregnant women and children from the 1958 British National Child Development Study initially were interested in the long-term effects of prenatal exposure to smoking on adolescent achievement test performance when controlling for the effects of secondhand smoke exposure during adolescents. They found it interesting that secondhand smoke exposure trumped prenatal exposure. The researchers note that the United States and the United Kingdom share similar statistics on smoking. Approximately one-third of women in their childbearing years are smokers. Ten percent to 15% of women reported smoking during pregnancy and up to 60% of children may be exposed to smoke at home.


The study did not reveal why secondhand smoke influence failure and the researchers were unable to include other known factors, for example, learning disabilities that could also affect learning and academic test performance. However, prior research has linked exposure to prenatal smoke to a higher risk of cognitive and academic defects, learning disabilities and impulsivity.

But few studies have looked simultaneously at the effects of both prenatal and environmental exposure to smoking on academic achievement beyond childhood and into adolescents. Collins currently is conducting a smoking treatment research study that is focused on reducing young children's exposure to secondhand smoke, pricking beyond behavior changes in the smaller steps. He is one of the few researchers looking at smoking in underserved high risk populations and helping them find solutions that don't require smoking abstinence as the first step goal.

So there you have it, yet another reason to get secondhand smoke out of your home.

About one million baby cribs made in China had been recalled by Simplicity Inc., a supplier to large retailers such as Walmart due to failures resulting in infant deaths. The US Consumer Safety Commission says it is a voluntary recall. These cribs have a dangerous gap which can lead to entrapment or the baby getting stuck when the drop-side detaches from the crib. This raises the risk of suffocation for the infant. The US Consumer Safety Commission says it has received two reports of infant deaths linked to these cribs including a nine-month old baby and another six-month old. These two deaths are linked to Simplicity Cribs with older style hardware where the drop-side was installed upside down.


This old style hardware cribs are also linked to seven infant entrapments and 55 other incidents. An investigation is underway after a one-year old child died in a new-style hardware Simplicity crib. In this case, the drop-side had also been installed upside down. It is vital that all parents, guardians and caregivers check that the drop-side is installed correctly. The installation air weakens the hardware and causes the eventual detachment of the drop-side from the crib. When the drop-side detaches, a gap is created into which the infant can fall and get stuck and potentially suffocate.

There had been two more incidents in which the drop-side was installed correctly using older style hardware. However, the US Consumer Safety Commission stresses that the risk of failure is significantly reduced if the installation is done correctly. The following Simplicity Crib models had been recalled: Aspen 3-in-1, Aspen 4-in-1, Nursery-In-A-Box, Crib N Changer Combo, and Chelsea and Pooh 4-in-1. And these Simplicity Cribs which have the Graco label have also been included in the recall, Aspen 3-in-1, Ultra 3-in-1, Ultra 4-in-1, Ultra 5-in-1, the Whitney, and the Trio.

There are specific model numbers which are affected and there are links in the Show Notes to take you to articles on the Internet which have all of these model numbers listed for you. The model number, by the way, are numbers that are written on the envelope attached to the mattress support and on the label attached to the headboard. According to the US Consumer Safety Commission, these cribs were made in China and sold in various types of large stores and regular shops throughout the USA. Consumers should check that the drop-side is installed the correct way.

So, dads out there, don't heave the directions into the trash and say, "I can put this thing together" because you want to make sure that the drop-side is installed correctly. And again, there are links in the Show Notes to Simplicity's website. There are also pictures that show you the right way and the wrong way to install the drop-side.


All right, the US Food and Drug Administration approved expanding the population for use of the nasal influenza vaccine, FluMist, to include children between the ages of two and five. Approval for the vaccine which contains a weakened form of the live virus and sprayed in the nose was previously limited to healthy children five years of age and older into adults up to age 49.

The goal of preventing influenza is now more attainable with the availability of FluMist for younger children, said Jesse L. Goodman, MD and director of the FDA Center for Biologics Evaluation and Research. This approval also offers parents and health professionals a needle-free option for squeamish toddlers who maybe reluctant to get a traditional influenza shot.

The US Centers for Disease Control and Prevention recommends that all children ages six months to 59 months receive a vaccination to protect against influenza. Studies have shown that children younger than five years have rates of influenza associated hospitalizations similar to those among individuals age 50 through 64 years, emphasizing the need for improved influenza prevention efforts for this younger US population. However, until today, there have only been two vaccines licensed in the US for children under the age of five. One influenza vaccine, Fluzone, is indicated for people over six months of age. Another vaccine, Fluvirin, is available for use in children age four and older.

Approximately 6,4000 infants and children, age six months to 59 months, received FluMist in three studies to support the vaccine safety and effectiveness. Two studies compared FluMist to placebo or no-vaccine both of which demonstrated the vaccine's effectiveness in preventing influenza illness. A third study compared FluMist to an inactivated or killed seasonal influenza vaccine shot. The result showed that there are 53 cases of influenza disease among 3,900 children who received FluMist compared to 93 cases among the same number of children who received inactivated or killed seasonal influenza vaccine shot.


Children under the age of two should not receive FluMist because there was an increased risk of hospitalization and wheezing for this group during the clinical trials. Commonly observed adverse events from the vaccine were generally mild and most often included runny nose and/or nasal congestion, as well as a slight fever in children two to six years of age. FluMist should not be administered to anyone with asthma or to children under the age of five with recurrent wheezing because of the potential for increase wheezing after receiving the vaccine. People who are allergic to any of FluMist components including eggs or egg products should also not receive the vaccine.

Incidentally, the flu vaccine should be out very soon at your doctor's office. So make sure you call him and get it just as soon as you can this Fall, because you don't know when your local supplies are going to run out. So it's important to sort of be on top of that.

New guidelines on the diagnosis and management of cow's milk allergy, published in the Archives of Disease in Childhood, are set to improve the standard of care of infants with cow milk protein allergy, the most common food allergy in children. The guidelines for the diagnosis and management of cow's milk protein allergy recommend only extensive hydrolyzed formulas such as Alimentum, Nutramigen, and Pregestimil, and amino acid-based formula such as Neocate. And they go on to warn about the risk of soy and other mammal milk such as sheep and goat in the treatment of cow's milk protein allergy.


Drawn up by the independent international task force called Act Against Allergy and supported by an educational grant from SHS International, a leader in the field of specialized clinical nutrition, the guidelines offer clear recommendations on how to diagnose and manage cow's milk protein allergy as well as two algorithms, one for breastfed infants and one for formula fed infants addressing all levels of disease severity. "These are the first practical guidelines on cow's milk protein allergy diagnosis and management and are specifically aimed at primary care physicians and general pediatricians," says Professor Yvan Vandenplas, pediatric gastroenterologist at the University of Brussels in Belgium and chair of the Act Against Allergy Task Force. "Our recommendations will assist in establishing CMA diagnosis and level of severity, offering clear guidance on their recommended management at each stage while debunking some of the misconceptions over the value of soy and other alternative milk sources in CMA management."

In their paper, the task force recommends against the use of soy especially in infants under six months old due to the risk of secondary intolerance which can be present in up to 60% of CMA infants. Alternative mammalian milk such as sheep, buffalo, horse, camel or goat present an even higher risk of cross reactivity and are not recommended at all in cow's milk protein allergy. Furthermore, milk substitutes based on greens, legumes or not such as rice, oat, pea or almond milk are to be avoided in infants and young children — and perhaps in moms and dads as well — due to their poor nutritional profile.


According to the Act Against Allergy guidelines, the only milk alternatives recommended for the effective management of cow's milk protein allergy are specialized hypoallergenic CMA formulas such as Alimentum, Nutramigen, Pregestimil, and Neocate. Amino acid-based formula such as the Neocate are the only ones recommended for all degrees of cow's milk protein allergy severity — in other words, mild moderate and severe. These formulas are based on amino acids-the building blocks of protein which are considered virtually incapable of provoking an allergic reaction while providing optimum nutrition for the infant. Immediate usage of these formula is also recommended in infants was suspected cow's milk protein allergy who are showing failure to thrive, such as insufficient weigh and/or length gain in order to rapidly stabilize the infant's physical development.

In cases of mild to moderate but not severe cow's milk protein allergy, the task force advises that an extensively hydrolyzed formula such as Alimentum, Nutramigen, or Pregestimil maybe sufficient. When milk proteins are broken down or hydrolyzed into small fragments, as happens in the production of extensively hydrolyzed formula, their ability to provoke an allergic reaction is reduced. However, if symptoms do not improve sufficiently, an amino acid-based formula such as Neocate should be considered. And if you have a baby at home with cow's milk protein allergy, make sure you save your pennies because all of those formulas are definitely expensive.

And finally, in our News Episode today, noise as background sounds helps children with attention deficit and hyperactivity disorder to concentrate. This is shown in a new research at Stockholm University. A study soon to be published in the Scientific Journal of Psychological Review and serving as the basis for a new dissertation, shows that concentration and memory are improved for such children when they listen to auditory noise while learning.


"The discovery is surprising since previous research is indicated with ADHD are easily disturbed in distracting environment," says Goran Soderlund, a former teacher who is now a doctoral student in the Department of Psychology at Stockholm University. He performed this research with Associate Professor Sverker Sikstrom of Lund University, also in Sweden.

A control group of children without ADHD perform better in silence. The researchers explain the difference and how noise affects the memory by pointing to how the signal substance dopamine controls the brain's activity. Children with ADHD have a low level of dopamine and therefore have low brain activity. Noise serves to stimulate the brain just enough for it to function better. Children without ADHD on the other hand have considerably more dopamine and a higher brain activity. For these children, noise can even be damaging since their brain is disturbed by too much background stimulation, which lowers their ability to concentrate and remember things. When they say noise can be damaging, they mean on learning and concentration, not on brain damage.

A follow-up study shows that the positive effects of noise are not limited to children with ADHD but also help normal school children who are somewhat below average. At the same time, the study showed that high achievement children performed less well in the presence of noise. This is also explained by the fact that below average children normally have lower levels of dopamine than high achievers.


"The conclusion is that noise is generally taken to raise dopamine levels, thereby improving concentration in school achievement and children with ADHD and also for below average achievers in general," says Goran Soderlund. "The conclusions we draw from our model are actually relatively easy to transfer to practical situations. The model helps us understand children with concentration problems and serves as a simple tool to adapt the school environment to children with ADHD. It provides a scientific basis for treatment other problem complex that's linked to concentration difficulties as in ADHD and can be a complement to pharmacological treatment. Low dopamine levels are one of several characteristics of ADHD but they also occur in Parkinson's Disease and in normal aging. Other patient groups with memory problems may also benefit from these findings."

So if you have a kid with ADHD at home and they want to do their homework with little background noise, it may not be such a bad thing.

All right. That's a wrap on this week's News Edition for Monday and we'll be back to wrap up the episode right after this break.


Dr. Mike Patrick: OK. Thanks go out today to Medical News Today for helping us out with our news program. Also to Christian Nordquist who wrote a couple of those news articles.

Also, I want to thank Vlad over at and make sure you support Vlad. He's the artist who does all of the artwork at our website, in the header and along the sidebar, and also the artwork that's featured in our Feed and also in the PediaCast shop, on all of the merchandise there. So make sure you support Vlad. He's a great artist and again you can find his things at He actually has a cool new program called Wallpaper Clock that changes your wallpaper every minute and it has a date in time on the wallpaper. It's really really cool. So you might want to check that out as well.


Tomorrow is Listener Day and our topics for discussion tomorrow — the importance of hand washing, sacral dimples in babies. So, if they have a little pit on their lower back in the middle, we're going to talk about that. Also, a parent has a question about a three-year-old with vaginal pain. So we're going to talk about all of that tomorrow.

Also, don't forget, again, I mentioned the merchandise in the PediaCast shop. There's no markup on the merchandise there on my part, so you get it at cost. And again, the advertising really is more important to me than making any kind of profit off of the merchandise in the PediaCast shop. And how do you find the shop? Just go to and click on the link in the sidebar.

So until next time, which will be tomorrow morning, this is Dr. Mike saying stay safe, stay healthy and stay involved with your kids. So long, everybody!


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