Lunch Box Recall, Gardasil, Bumper Pads – PediaCast 056

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Announcer 1: This is PediaCast.


Announcer 2: 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.& This is Dr. Mike coming to you from BirdHouse Studio.& It is episode 56 and as Katy pointed out this is going to be a news edition.& We're going to talk about a recent lunch box recall in the State of California.& Also some new information on Gardasil, that's the vaccine that protects against HPV.& The evil of bumper pads, I'll explain what that's all about.& And we have some other news stories for you, too, that's coming up.

I have to say it's great to be back.& You'll notice those of you who watch the feed carefully, it's been a week and a half since we've had a show out.& We were on a family vacation out in California.& We went out there and the folks in Southern California were truly hospitable.& So any of you that I came across, thank you very much for making our vacation such a great one.& We went out to Disneyland.& We're fortunate enough as a family to be members of the Disney Vacation Club and we go to Disney World a lot, but that was the first time we've been out to Disneyland.& And we had a great time.& It was really a lot of fun.


We visited the San Diego Zoo, that's always a great place to go.& And probably the highlight of the vacation, we toured the USS Midway, which was an aircraft carrier of the United States Navy from the mid-40s until the early 90s.& And my father-in-law actually served in the navy on that ship, so he was able to show the grandkids and his daughter and his grandson (Why am I saying grandson?), his son-in-law and his grandson and his granddaughter, too.

Anyway, he was able to show us around the ship and show us exactly where he worked.& He spent most his time in one of the engine rooms and it just so happens that on the Midway there are four engine rooms and the one that they have opened to the public as part of the museum is the one that he actually was in.& So that was pretty cool.

If you find yourself in San Diego, I would definitely reserve a day to go to the Midway.& Obviously, we had a guided tour from someone who had been on the ship, so we spent a lot of time there.& But we could have spent a couple more days on the ship to be honest with you.& It's so big and the folks there do a nice job with, they have this headphone system that you can walk around and you punch in number into this little thing you wear around your neck and then a person tells you all about that thing that that part of the ship or the thing that you're in front of.& So it's a pretty sleek system, really nice.

And I go to this much detail because even if you don't home-school, I think parents are still responsible for their children's education and this is living history.& So if your family finds themselves in Southern California, definitely take the kids to the USS Midway, the aircraft carrier museum.


All right, don't forget if there's a topic that you would like us to discuss on PediaCast, it's really easy to get a hold of me, just go to and click on the Contact link.& You can also email and the voice line is 347-404-KIDS, 347-404-K-I-D-S.

Don't forget the information presented in PediaCast is for general educational purposes only.& We do not diagnose medical conditions or formulate treatment plans for specific individual.& If you have a concern about your child's health, call your doctor and arrange a face-to-face interview and hands-on physical examination.

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at And with that in mind, we'll be back with the News Parents Can Use, right after this short break.



Our News Parents Can Use edition is brought to you in conjunction with a news partner, Medical News Today, the largest independent health and medical news website.& You can visit them online at The California Department of Public Health recently urged consumers to stop using certain lunch boxes that have been distributed at health fairs and other events after three lunch boxes tested positive for elevated levels of lead.

The lunchboxes that tested positive were bought from TA Creations, a company with factories in, well guess where, China.& The lunch boxes found to be contaminated were made of green canvas, with a black shoulder strap and show the logo "EAT FRUITS & VEGETABLES AND BE ACTIVE".& About 56,000 of them have been distributed throughout California at health fairs and related events.

The California Department of Public Health is also testing other lunch boxes it has been distributing for potential contamination with lead.& These lunch boxes were used to promote: Network for a Healthy California Program and the Special Supplemental Program for Women, Infants and Children, also known as WIC.& Around 300,000 of them have been distributed.

Director of the CDPH, Dr Mark Horton urged people not to use any of the lunch boxes and especially to keep them away from infants and young children.& "CDPH will no longer use lunch boxes until such time as we are assured that every lunch box is safe," he added.& Horton said the CDPH was also assessing the safety of all its health promotion items.& Anyone who has these lunch boxes should take them back to where they got them, or if they can't do that, take them down to their local household hazardous waste (HHW) collection point for disposal.

The California Department of Public Health knows of no cases of lead poisoning happening as a result of the lunch boxes and this recall comes in the wake of numerous product recalls due to suspected lead contamination.& Many of these products were made in China and many include children's goods, including toys.

The US Centers for Disease Control and Prevention (CDC) has issued nearly 30 product recalls of children's toys so far this year, including: Thomas and Friends Wooden Railway Toys, Sarge die cast toy cars, Sesame street toys, various Barbie accessories, Big Big World, Bongo Band Toys and many others.

Other products the CDC has recalled due to suspected lead contamination include furniture, children's jewelry, various craft items, office supplies and "foodware….& Children are more vulnerable to lead than adults, and it can affect their mental and physical development.& The CDC estimates that nearly one million US children under five have high levels of lead in their blood.& One of the biggest hazards is house paint, especially in older houses.

Many children do not show physical symptoms of lead poisoning because they can be subtle and build up gradually.& Symptoms of lead poisoning include vomiting, diarrhea, convulsions, anemia, loss of appetite, abdominal pain, constipation, irritability, fatigue, difficulty sleeping, headaches and eventual coma.& In extreme cases it can be fatal.

And if you check out the Show Notes, we do have some links to photographs of the recalled lunch boxes, a list of disposal sites and the information on childhood lead poisoning all from the California Department of Public Health.


A new study on Gardasil sponsored by Merck who manufactures the vaccine, suggests that it protects against more types of Human Papillomavirus (HPV) than at first thought and it now offers protection against strains of HPV that cause 90% of cervical cancers.

The US Food and Drug Administration (FDA) approved Gardasil last year as a new vaccine against cervical cancer and other diseases in females caused by HPV.& This was on clinical evidence showing it protected against HPV 16 and HPV 18, which cause 70% of cervical cancers and HPV 6 and HPV 11, that cause 90%of genital warts.

Now a new study of 11,000 girls and women aged from 15 to 26 found the vaccine to be 38% effective against 10 further types of Human Papillomavirus (HPV) that are thought to cause 20% of cervical cancers. &

The research is the work of Dr. Darren R. Brown, professor of medicine, microbiology and immunology at Indiana University School of Medicine in Indianapolis and his colleagues.& It was presented at a meeting of the American Society for Microbiology.& Brown conducted another study earlier this year where he showed that Gardasil was continuing to be nearly 100% effective at preventing infection by HPV 16 and HPV 18 in its post market phase.

The new findings also show that Gardasil is 45% effective against HPV types 45 and 31, also linked to cervical cancer.& The vaccine was successful at preventing 62% of precancerous lesions that were due to those two strains.& Brown told WebMD that it did not come as a surprise to find that the vaccine protects against other HPV strains than first thought because the strains are all related.

There has of course been much controversy in the U.S. about cervical cancer vaccination because for it to be effective girls have to be vaccinated before they reach sexual maturity, at age 11 and 12 according to recommendations from the Centers for Disease Control and Prevention (CDC).

Many parents and interest groups say this interferes with parental rights and at this age girls are too young for this type of intervention and that it might even promote promiscuity.& Dr. Brown told WebMD that he hoped this news will encourage more parents to have their teenage girls vaccinated.

HPV is the most common sexually transmitted diseases among Americans.& The CDC estimates that about 6.2 million Americans are infected with genital HPV every year and that half of all sexually active men and women will get at some time in their lives infected with the virus.

Worldwide, cervical cancer is the second most common cancer among women, with 470,000 new cases and 233,000 deaths a year attributed to the disease.& Among American women, there are nearly 10,000 new cases of cervical cancer and 4,000 deaths, every year.

In most women, HPV is mopped up by the body's immune system, and they do not go on to develop health problems. However some strains cause abnormalities in cells that line the cervix, causing precancerous lesions that can become cancerous many years later.

It is important to continue with cervical cancer screening even after being vaccinated against HPV.

And you can look in the Show Notes for a link to the WebMD article describing this news study, as well as an HPV information site from our friends at the CDC.& And of course you can find the Show Notes at


Children with asthma who improve their physical fitness are likely to experience beneficial effects on disease control and quality of life, according to a study published recently in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine (ACSM).

The results show aerobic training to be effective in improving cardiopulmonary fitness and decreasing daily use of inhaled steroids in asthmatic children, outcomes that should have positive implications for disease management in a group that tends to have lower cardiorespiratory fitness than their healthier counterparts.

"Children who experience breathing restrictions caused by asthma sometimes fear inducing breathlessness by exercise, which can cause physical deconditioning over time," said Dr. Celso Carvalho, Ph.D., an author on the study.& "This is where we often see patients with asthma having lower fitness levels.& Physical training, properly supervised, is not only a possibility for this group with asthma, but also a management strategy for their symptoms."

The study enrolled 38 children with moderate to severe persistent asthma, randomly assigned to either a training group or a control group.& Exercise performance and exercise-induced bronchoconstriction was evaluated 16 weeks apart, while daily doses of inhaled steroids and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) scores also were recorded.

Asthmatic children, even with moderate to severe disease, showed significant improvements in their aerobic capacity after the training program and a reduction in exercise-induced bronchoconstriction, which induced breathlessness and is a characteristic response to exercise present in most patients.

Daily doses of inhaled steroids were reduced in trained patients by 52%, but remained unchanged or increased in the control or untrained group.& When compared to controls, these children also reported a significant improvement in health-related quality of life.

The authors emphasize that training should be supervised and performed in children properly medicated and the actual impact of physical training on clinical indicators of disease control is unknown.& While these data suggest an adjunct role of physical conditioning on clinical management of patients with more advanced disease, additional research is warranted to discover the contribution of exercise on asthma symptoms and its manifestations.


In toddlers, a large part of enjoying a good book is getting immersed in the life of a character, especially a character's thoughts and feelings.& A new University of Waterloo psychology study shows that preschoolers can already perform this impressive perspective-taking feat and get into the minds of story characters.

The study used an innovative approach to explore children's storytelling ability, focusing on how well they comprehend stories instead of how well they tell them. The study, entitled The Emergence of the Ability to Track a Character's Mental Perspective in Narrative, was published in Developmental Psychology.

"Children around the ages of three to five are fairly limited in their verbal abilities and many previous studies have relied on methods requiring children to tell a story orally, potentially underestimating what they can do," says lead researcher Daniela O'Neill, who did the study with graduate student Rebecca Shultis.

O'Neill, an associate professor of developmental psychology and head of the UW Center for Child Studies, says that's why the study introduced an innovative approach to look at children's storytelling ability.& It offers a new method to evaluate storytelling that can pick up differences in the abilities of the younger children.

"I believe children as young as age three to five are developing in important ways with respect to their narrative ability, we just need new ways to look at it."

"In essence, rather than looking at how children are able to tell stories, it looked at how children understand stories and whether, like adults, children build up a 'mental model' of the story," O'Neill says. "By this, I mean, are children, like adults, able to build up a model of the story in their mind and 'step into the mind' or to speak, of a character.

"It turns out, from the results of our study, that indeed this is one important way in which children appear to be developing with respect to their understanding of stories during the preschool years."

The researchers had the children listen to a story about a character who was in one location, but was thinking about doing something in another.& "Tracking the thoughts of characters to different locations they are thinking about is something we do very easily as adults and really is an impressive perspective-taking feat," O'Neill says.

"But can children also do this? It turns out that five-year-olds can, pretty much like adults, but that three-year-olds have much more difficulty doing this."

The youngest children tracked a character if he or she physically moved between two locations, but they did not seem able to track a change in location if it only happened in the character's mind.& In the study, two models were placed in front of the children depicting the two locations — a barn and a field.& In both locations there was a cow.& Children were told that the character was in the barn, but was thinking about feeding the cow in the field. Then, immediately after this sentence, children were asked to point to the cow.

"This is an ambiguous request, since there are two cows present," O'Neill explains.& "But we hypothesized that if children were tracking the thought of the character to the new thought-about location or the field, then they would point to the cow there.& If they were only able to think about the character where the character physically is, then they would point to the cow in the physical location or the barn."

Well it turns out five-year-olds pointed to the cow in the thought-about location and three-year-olds pointed to the cow in the character's physical location, and only switched if told the character had actually gone to the other location.

"We are excited about these results because they help us to better understand how children's narrative ability is changing and developing very early on in a new way we didn't know about before when studies focused mainly on having children tell stories which they are really not very good at yet," O'Neill says.

"Children with delays in their language also often have difficulty with comprehending and producing narratives," O'Neill says. "This can become quite an issue once children reach school and are faced with many more tasks that require good story comprehension skills."

The study potentially provides a new way to understand some of these difficulties and differences in perspective-taking ability that may hinder story comprehension and production.


And finally, the hazards of bumper pads in baby cribs.& Although bumper pads are theoretically designed to prevent injury to a baby while in the crib or bassinet, the risk of accidental death or injury to an infant from using them outweighs their possible benefits, according to a new study by pediatric researchers at Washington University School of Medicine in St. Louis.

In the study, which appears in the September 2007 issue of The Journal of Pediatrics, the researchers reviewed three U.S. Consumer Product Safety Commission databases for deaths related to crib bumpers and crib-related injuries from 1985-2005.& They found 27 accidental deaths reported by authorities of children from one month old to two years old that were attributed to suffocation or strangulation by bumper pads or their ties.& They also found 25 non-fatal injuries in infants attributed to bumper pads.

Of the deaths in which there was a formal investigation, 11 infants likely suffocated when their faces rested against the bumper pad, 13 infants died from being wedged between the bumper pad and another object and three infants died from strangulation by a bumper tie.

"Many infants lack the motor development needed to free themselves when they become wedged between the bumper pad and another surface," said Bradley Thach, M.D., professor of pediatrics and staff physician at St. Louis Children's Hospital who researches infant apnea and Sudden Infant Death Syndrome.& "They are likely to suffocate because they are rebreathing expired air or their nose and mouth are compressed."

Thach said both soft or firm bumper pads pose risks. "If the pads are too soft, the baby's nose or face can get pressed up against it, and the baby suffocates," he said.& "If they are too firm, the baby can climb up on the pads and fall out of the crib."

The researchers examined 22 retail crib bumpers for features that could be hazardous to infants.& They graded the bumpers for softness and measured the potential space between the bottom of bumper and mattress, the width of the bumper pads and the length of the fasteners that attach the bumper to the crib. Current manufacturing standards state that bumper pads should not have ribbons, strings or ties longer than nine inches, but the researchers found two with fasteners longer than nine inches.

Thach said all of the retail bumper pads they examined were hazardous because they all potentially leave a space between the pad and the mattress where babies can get their heads wedged.& The researchers indicated that their study is limited because of underreporting of cases and lack of a consistent protocol of scene investigations and autopsies.

Thach recommends that parents not use bumper pads in cribs or bassinets.& "I don't think bumper pads are doing any good," he says. "Although the deaths and injuries may be rare events, they are preventable by eliminating the use of bumper pads."


All right.& That's it for today's News Parents Can Use edition and we'll be back to wrap things up, right after this.


All right.& Thanks go out this week to the folks at Medical News Today and in particular, Catharine Paddock, who wrote some of the articles and stories for you this week.& Also thanks go out to Vlad over at for doing the artwork for our website and the feed, we really appreciate that.& Be sure to check out his site, again, that's

Also don't forget the PediaCast Shop is open for your shopping enjoyment and there's no mark-up on our part.& You basically get the T-shirts at our cost and of course buying those T-shirts helps spread the word about PediaCast, which of course is always appreciated.

There's more to come this week including catching up with answers to your questions and a special guest later in the week.

Until next time, this is Dr. Mike Patrick staying… trying to get my tongue untied.& Look folks, I've been on vacation, so you got to give me a little break.& All right, this is Dr. Mike, saying stay safe, stay healthy and stay involved with your kids.& So long everybody!


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