Chronic Snoring, Mouth Blisters, Strep And Ibuprofen – PediaCast 116

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  • Chronic Snoring
  • Reliability Of A Child's Memory
  • Mouth Blister
  • Strep And Ibuprofen
  • Candle Carcinogens




Announcer: Bandwidth for PediaCast is provided by Nationwide Children's Hospital, for every child, for every reason.


Announcer: Welcome to PediaCast, a pediatric podcast for parents. And now direct from Bird House Studios, here's  
your host Dr. Mike.


Dr. Mike Patrick: Hello everyone and welcome to PediaCast, a pediatric podcast for moms and dads. This is Dr. Mike coming to  
you from Bird House Studio. And of course as always I'd like to welcome everyone to the program. It is episode 116.  
Snoring, Motrin, okay or ibuprofen — I guess I probably shouldn't use a brand name, you know, without promotional  
consideration. And candles, that's the other thing we're going to talk about today. Before we get started I have to tell you it  
has been a rough time here in Central Ohio particularly last week.


We just had tons and tons of rain. A little bit of sunshine over the weekend but for what I understand more rain is on the  
way coming up this week. And I find it kind of interesting, someone called in a radio station in Columbus and they  
summed it up really well. They said Ohio has 5 seasons. You have spring. You got summer. You got autumn. You got  
winter and crappy. And right now we are in the midst of the crappy season so I agree with that. It seems like every March  
you know this sort of thing happens. We had several inches of rain a couple of weeks ago and the ground really was just  
totally saturated.


We had standing water in our yard and places and we've got couple acres and we have some low areas. And sometimes  
we do get some standing water when it rains really hard. But a couple of weeks ago we had standing water in places that  
I've never seen as have standing water before in the 10 years that we've lived in this particular house. And then on top of  
all that we get the 17 inches of snow that was the almost blizzard and then of course that all melted and pretty much had  
nowhere to go.


And then last week we get several more inches of rain. So then we've had some leaks in the house or garden window,  
and the kitchen, which is not that old, decided to start leaking. We had a garage roof leak which was fixed a couple of  
years ago and we had the dry wall replaced and guess what it, started leaking over the weekend. So Karen gets stressed  
out a little bit more about these things than I do. And you want to check out the Pediascribe blog and her post called  
appropriately "I'm Sick of Being a Grown Up."


And it pretty much sums up our past week last week. So you might want to stop by the blog and send her some love in the  
comments section of that post because she's been pretty down with the weather. On the bright side good news in Central  
Ohio a big welcome to Columbus, to Terrell Pryor. He was the number 1 high school quarterback recruit and he  
announced Wednesday that he intends to be in Ohio State Buckeye rather than a Michigan wolverine next fall. Good  
choice, Terrell, very good choice.

All right, so what are we talking about today? We have a couple of new stories. One is on chronic snoring, and should you  
get your kids tonsils adenoids taken out because of chronic snoring? We're going to talk about that also reliability of a  
child's memory that is coming up in the news department. And then we have some listener questions. One about a mouth  
blister, we're going to talk about strep and ibuprofen or Motrin or Advil if you want to go with the brand names.


And then we're going to discuss candle carcinogens. Are candles in your house dangerous? So that's all coming up after  
the news. We'll talk with answering your questions. Don't forget if there's a topic that you would like us to talk about on  
PediaCast, it's really easy to get ahold of us. Just go to and click on the contact link. You can also email And just make sure if you email in let us know where you're from cause that's always of interest.  
And then of course you can also call the Skype line and phone your question in at 347-404-KIDS, that's 347404-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 individuals. 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 news parents can use right after this short break.




Our news parents can use is brought to you in conjunction with news partner Medical News Today, the largest  
independent health and medical news website. You can visit them online at

A new study from Cincinnati Children's Hospital Medical Center reports, surgery to remove children's tonsils and  
adenoids to treat sleep disorder breathing, also known as obstructive sleep apnea, may be successful on the short term;  
however, children who gain weight rapidly and African American children tend to relapse or even worsen.

The study is published in the American Journal of Respiratory and Critical Care Medicine. Adenotonsillectomy or removal  
of the tonsils and adenoids is a surgery that is frequently performed on children. About 19 per 10,000 children in Canada,  
50 per 10,000 in the United States and 115 per 10,000 in the Netherlands received the surgery. Although it is often the  
first treatment option for sleep disordered breathing in children, many patients are only provided with short term relief  
from their problems.


Dr. Raouf Amin, director of pulmonary medicine at Cincinnati Children's says, "The high rate of recurrence we observed  
in both obese and non-obese children indicates sleep disordered breathing is a chronic condition."

Amin and colleagues used a sample of 40 healthy children ages 7-13 whose parents and otolaryngologist agreed to treat  
chronic snoring with adenotonsillectomy. Thirty sex- and age- matched children who are not having the surgery were  
recruited as a control group. At the time of recruitment, each child received a sleep study which was repeated at 6  
weeks, 6 months and a year after the surgery for both the treatment and control groups.


Six weeks after the surgery most of the children with sleep disordered breathing improved. However, the rate of relapse  
after 1 year had no correlation with the 6 weeks score. Instead traits such as obesity, worse sleep disordered breathing  
at base line, rapid weight gain, and being African American were associated with children who relapse. Most post  
adenotonsillectomy outcome studies focused on the assessment of sleep disordered breathing 6 to 16 weeks after  

Resolution of symptoms during this window is usually interpreted as a cure for the disorder. But this study reports for the  
first time that the longitudinal outcome of adenotonsillectomy in healthy children is strongly influenced by weight and  
African American race. Before surgery, about 50% of the non-obese children and 67% of the obese children had what  
you could classify as severe obstructive symptoms. A year after surgery 27% of the non-obese kids and 79% of the  
obese ones saw a return of severe disease.


This indicates that the surgery was significantly more effective in non-obese children after 1 year. Children who were  
obese at base line and those who had rapid weight gain were more likely to relapse than those who lack these  
characteristics. Dr. Amin sums up by saying, "Sleep disordered breathing appears to be a chronic disorder that is clearly  
linked to other medical problems." Given the rate of relapse he advocates long term follow-up of children with sleep  
disordered breathing and including close monitoring of weight gain.

The US legal system has long assumed that all testimony is not equally credible that some witnesses are more reliable  
than others. In tough cases with child witnesses, it assumes adult witnesses are more reliable. But what if the legal  
system has it wrong? Professors Valerie Reyna and Chuck Brainerd — both from Cornell University — argue that like the  
two-headed Roman god Janus, memory is of two minds — that is, memories are captured and recorded separately and  
differently in two distinct parts of the mind.


They say children depend more heavily on a part of the brain that records, "what actually happened," while adults depend  
more on another part of the brain that records, "the meaning of what happened." As a result, they say, adults are more  
susceptible to false memories, which can be extremely problematic in court cases.

This research, funded by the National Science Foundation, in Arlington, Virginia, sparked more than 30 follow-up memory  
studies, many of them also funded by NSF. The researchers review the follow-on studies in an upcoming issue of  
Psychological Bulletin.

The report will show that meaning-based memories are largely responsible for false memories, especially in adult  
witnesses. Because the ability to extract meaning from experience develops slowly, children are less likely to produce  
these false memories than adults, and are more likely to give accurate testimony when properly questioned.


The finding is counterintuitive; it doesn't square with current legal tenets, and may have important implications for legal  

"Because children have fewer meaning-based experience records, they are less likely to form false memories," says Dr.  
Reyna. "But the law assumes children are more susceptible to false memories than adults."

The court's reliance on adult testimony has a long history. Before the early 1970s, children younger than eight years old  
rarely testified, because they failed the court's competency requirements.

Then in the 1970s, when statistics showed an increase in the number of child abuse cases, courts were forced to allow  
the testimony of young victims, only to reemphasize adult testimony in the 1990s, when some children's testimony was  
proven to be unreliable.


"Courts give witness instructions to tell the truth and nothing but the truth," says Dr. Brainerd. "And this assumes  
witnesses will either be truthful or lie, but there is a third possibility now being recognized–false memories."

According to Brainerd, "Things are about to change radically."

Traditional theories of memory assume a person's memories are based on event reconstruction, especially after delays  
of a few days, weeks, or months.

However, this newly formed Fuzzy Trace Theory hypothesizes that people store two types of experience records or  
memories: verbatim traces and gist traces. Verbatim traces are memories of what actually happened while gist traces  
are based on a person's understanding of what happened, or what the event meant to him or her. Gist traces stimulate  
false memories because they store impressions of what an event meant, which can be inconsistent with what actually  

False memories can be identified when witnesses accurately describe what they remember but those memories are  
proven false based on other unimpeachable facts.


When gist traces are especially strong, they can produce phantom recollections–that is vivid memories of things that did  
not happen, such as remembering a robber brandishing a weapon and made threatening statements when in truth he did  

Brainerd argues that because witness testimony is the primary evidence in criminal prosecutions, false memories are a  
dominant reason for convictions of innocent people

Recently, in Cook County, Illinois, more than 200 murder confessions were identified as being based on adult's false  
memory reports because they conflicted with unimpeachable facts. For example, a person may have falsely remembered  
being in one location, but a sales receipt showed that he was in another location at the same time a crime was  

In child abuse cases where the law gives the benefit of the doubt to adult testimony, the results can be even more  
disconcerting. "Failure to recognize differences in how adults and children produce memory unfairly tilts the U.S. legal  
system against child witnesses.


"Children do not have the same fullness of emotional and intellectual experience as do adults when it comes to deriving  
meaning from situations, so, meaning-based memory is less likely to influence a child's testimony.

The researchers say their transformative "two-mind" memory approach can reduce the number of false memories in court  
cases and give more validity to children's testimony.

Professors Reyna and Brainerd developed several mathematical models associated with Fuzzy Trace Theory that can  
be used to predict memory outcomes in both adults and children.

The models, which test memory, have been used to determine ways in which attorneys, investigators, law enforcement  
officials and others can ask questions to help people access verbatim memories while suppressing false memories. The  
researchers say using neutral prompts to cue witnesses can help them remember what actually happened.

Reyna and Brainerd also say returning a witness to the scene of an event in a highly neutral way can cue verbatim  
memories and help the legal process.


The models provide the most accurate information to date on the causes of false memories. And using them,  
researchers can determine with surprising accuracy when a person accesses both verbatim and gist memory.

That's interesting! I mean it's not purely pediatric medicine but it does involve kids. So I'm going to let it count. Alright we'll  
be back to answer your questions right after this.



Okay first up on our listener segment is a mystery listener. And our mystery listener says, "Dr. Mike I've been listening to  
your show since the very beginning. I've even had the privilege of meeting you in person. Although yours isn't my favorite  
podcast I listen to, I enjoy it quite a lot. And in your most recent episodes I have noticed an increase in audio quality. Are  
you kissing up or what? I have a quick question for you. In the morning there's a little bump on my lower lip just on the  
inside. The bump is clear and when I pop it a clear liquid and a hint of blood comes out. This has been happening almost  
every morning for a couple of weeks."


"And it's only in the morning. I hope you can give me a little insight into what might be causing this and perhaps give me  
something to prevent it. A doctor with your experience should have no problem diagnosing this. Hope you can help,  
signed a big fan of PediaCast. P.S. I wear a retainer at night as well. I don't know if this has anything to do with it though  
because I have had a retainer long before this became a problem plus I wear my retainer during the day and only on my  
upper teeth. Since the problem is on my lower lip I'm not concerned about this being the issue."


Alright you know usually I don't answer questions and give specific medical advice. But let's reveal the mystery listener.  
It's my daughter.


Now how sad is that? Okay we're so busy that Katie has to email me with her troubles. No actually she doesn't have to.  
It's just her choice being a wise acre. That's all. All right, Katie, here's the deal. Well you know and let me say this too, I'm  
not going to answer you other than here, so if you listen to the show then you'll find out. If not you're not just going to get  
your answer.

Katie the problem is your retainer. You grind your teeth at night. I know this for a fact I've heard it. And when you grind your  
teeth I'll bet your bottom lip rises and rubs against the retainer. And even though the retainer encases you're upper teeth I  
think it's your bottom lip that rub against it. So what do you do? Well, we have some triamcinolone dental paste which is a  
steroid in our vacation medicine bag and I bet if you put that on the spot twice a day for a week it'll solve your problem.

Alright to the rest of you out there thanks for allowing me a bit of self indulgence, family style. You know ,I mean she's got  
to ask question to the website like a smarty pants and she can listen to it in the show. And you know, Kate, if you just ask  
me in person I would have gladly helped you out much more quickly. But no you had to do it your way.


All right, folks, let's move on. The next is Jack from Baton Rouge Louisiana and Jack says, "Dr. Mike thanks for all the  
time you spend on the show and all the good information that you put out. I really appreciate it. I'm a paramedic down here  
in the South as well as a proud father of a strapping 13 1/2 month old little man. He's been getting the regular crud here  
recently. But slowly it has worsened. Two weeks ago he had bilateral ear infections and was treated with azithromycin  
and responded well."

"Today we had scheduled follow-up with our pediatrician. Before the appointment he began to run a fever of 102.5  
degrees Fahrenheit and we treated it with the usual Tylenol – Motrin swap. Later the doctor's office he had a rapid strep  
test that came back negative and was given the diagnosis of tonsillitis. When I asked our pediatrician about the treatment  
he indicated to treat the symptoms like fever and throat discomfort and I responded by saying "okay so the Tylenol and  
Motrin switch."


"And he said if it was strep, the Motrin could make it worse. I asked 4 colleagues — 2 nurses, a pharmacist and a  
physician's assistant about why this may be? But no one could provide me with an answer. After 2 hours of looking on the  
internet, still no answers. I thought hey let's ask Dr. Mike! He always says insight. So here I am. Can you help me  
understand this direction from my pediatrician? I did want to ask him because there was a patient that came in right after  
us that was very sick and he was performing the necessary tasks to have him admitted to the hospital. I believed I could  
figure it out on my own. Pease help. Thanks a whole bunch, Jack, also known as Asus dad."

All right Jack well thanks for your confidence and as it turns out I do think I can help you out with this. Back in the 1990's  
there were several case reports of flesh eating strep skin infections in kids with chicken pox who were taking a what we  
call an NSAID, an N-S-A-I-D, also known as a non-steroidal anti-inflammatory drug. And examples of those kinds of  
drugs, one example is ibuprofen such as Motrin or Advil.


So and a subsequent retrospective study confirmed this association. So in other words kids who had chicken pox were  
more likely to get an infection of the skin with flesh eating strep if they were taking ibuprofen.

Okay so first what is flesh eating strep? I think that's a good place to start. Well it's a rare strain of group A strep which is  
also the organism involved with strep throat. But this is a rare strain of group A strep that makes a toxin that is capable of  
breaking down connective tissue causing large ulcerations in the skin.


And the lower — actually not just the skin but also the lower, what we call the fascial layer which is below the skin. And this  
is a condition then when you have these ulcerations called necrotizing fasciitis. The connective tissue that breaks down  
again it's deep down beneath the skin. It doesn't actually break down the surface of the skin which is acting as a  
protective barrier. So the skin that this toxin dissolves is actually down deep and as long as your skin is intact even if that  
bacteria is on the outside of your skin, the toxin is really not going to have much effect.

But with chicken pox you have tons of open source which gives surface bacteria easy access to these deeper tissues.  
And normally the immune system would keep these bacteria and check but ibuprofen is a non-steroidal anti-inflammatory  
drug and the key word here is anti-inflammatory. Inflammation you know is a byproduct of our immune system so you cut  
down an inflammation and you also cut down on at least part of the immune system's ability to perform.


So really this condition is, or the situation is sort of like the perfect storm — bacteria on the skin are able to get deep  
because of the chicken pox source. And if that bacteria happens to be group A strep and if that strep happens to be the  
rare form that makes the toxin and if it gets down deep enough, and if your child's taking ibuprofen and if that ibuprofen  
affects the immune system just right, then that strep can thrive, make its toxin and digest the deep structures of the skin.  
And basically you get a complication of flesh eating strep with a kid that has chicken pox who's also taking ibuprofen.

So really this all make sense in terms of why it can all fit together but what about strep throat? I mean that's the real  
question here.


Well to my knowledge I have seen no report or study implicating ibuprofen as a worsening agent for group A strep  
infections in the throat. The association appears to be limited to the unique situation that I described. So you have to have  
that rare form of Group A strep, the rare strain that makes the toxin. And only when it is infecting the skin and only in the  
phase of chicken pox disease, and only when the child is also taking ibuprofen at least in terms of this higher risk for this  

Now the next logical question is this: if ibuprofen and other non-steroidal anti-inflammatory drug suppress the immune  
system, should we ever use those in the phase of illness? Well non-steroidal anti-inflammatory drugs work by reducing  
the effectiveness of something called cell mediated immunity. They don't affect other aspects of the immune system  
including the proper function of antibodies. So in most circumstances including throat infections with the far more  
common non-toxin making strains of group A strep, non-steroid anti-inflammatory drug use such as ibuprofen which is in  
Motrin and Advil does not appear to significantly impair the immune's system ability to fight the infection.


So honestly I think your doctor just simply a little confused on his facts. There is an increase risk of acquiring flesh eating  
strep infection if ibuprofen is used in the presence of active chicken pox disease. But there are no studies to my  
knowledge as of the day I'm recording the show that suggest ibuprofen will make routine strep throat any worse nor is  
there any evidence to support the idea that ibuprofen will turn common non-toxin making strep into the rarer toxin  
producing type.

But by all means if anyone has evidence to the contrary please let me know and I'll be happy to pass it along. By the way  
ibuprofen isn't the only drug you should avoid with an active chicken pox infection. You'll also have to avoid using aspirin  
and/or other drugs that contain aspirin-like compounds called salicylates with chicken pox and actually other viral  
infections too including influenza and even the common cold because of an association with viral illnesses in aspirin it  
can lead to something called Reye's syndrome.


And Reye's syndrome isn't often a deadly condition that ravages the liver and brain. So here are two the examples of why  
chicken pox vaccine is a good idea and there are many complications possible with active chicken pox infection  
including flesh eating strep, Reye's syndrome, meningitis, encephalitis and something called pneumonitis which is an  
inflammation of the membranes that cover the lungs which can be quite serious.

When I was in training, you know just over 10 years ago now, before the chicken pox vaccine saw routine and widespread  
use we always had at least 1 kid in the intensive care unit at Children's with complications of chicken pox. So you know  
it's not always a benign disease that's okay for kids to get. I do have some links in the show notes for you. One is the to  
original article linking ibuprofen and flesh eating strep in the face of chicken pox.


It's called a case control study of necrotizing fasciitis during primary varicella, and it was a post in the journal, Pediatrics  
in April of 1999. And I have link to that article for you if you're interested in the show notes. And then for more information  
on Reye's syndrome since we just mentioned it, the National Reye's Syndrome Foundation, it does have lots of  
information about that disease. And we'll have a link to that in the show notes as well. So Jack, the bottom line is would I  
give ibuprofen to my own child who had strep throat, with the knowledge I possess today, yup sure I would!


Alright next comes Lydia from Birmingham Alabama and Lydia says I've been reading about carcinogens released when  
burning certain candles and that paraffin candles are as dangerous to the lungs as second hand smoke. I've also read  
that no agency regulates or oversees of candle industry. Do you know if any of these is true and would you please discuss  
what you think about burning candles around babies? Thank you and love your podcast.

All right let's talk about this. There are basically two sources of chemicals being emitted from candles so 2 sources of  
candle emissions. One is going to be chemicals arising from the burning wick and the other is going to be chemicals  
arising from combustion of the candle itself so let's talk about both of these. First we'll talk about wicks. For a long time  
lead core wicks were common even clear up through in the 1990's and into 2001.


Lead core wicks were common because it provided the cheap way to make a wick rigid. And it was thought that since  
the covering of the wick is really what burned that the lead beneath that was safe and did not enter into the environment.  
But a 2002 study in the journal Science of the Environment showed that there was an increase in lead particles in rooms  
with candles that had lead core wicks. And I do have a link in the show notes to that or at least the abstract of that study. It  
was called "Lead and Candle Emissions."

In response to that study in 2003, the US Consumer Product Safety Commission banned lead-cored wicks in all candles  
at least any new candles that was being sold in the United States. And that included domestic candles and imports, so if  
you have a candle that was made after 2003 and you bought it since 2003 you can be assured that as long as the  
company is following the rules that it would not contain lead in the wick.


But if you have a candle that is pre-2003, it is possible that the wick could contain lead which might be a problem.  
Today's wicks are made out of cotton or a mixture of cotton and paper and if the candle calls for a more rigid wick then  
zinc core and tin core which have not been shown to release any harmful particles are used. You can also check out, and  
you know I thought to myself, where do we usually get candles? With my family we usually get them at Yankee candle and  
you know give them as gifts.

So I thought hey I'll check out Yankee candles website. And sure enough they have a statement on lead cored wicks and  
they assure the consumer that they do not use any lead cored wicks in any of their candles. And I have a link in the show  
notes to that as well. And then I also have a link to the National Candle Association and their statement on wicks and lead  
and they're all for the ban.


One more link that I wanted to put out is– Snopes is a place online where they research kind of urban legend. It's kind of  
the myth busters of the web world. And I do have a link to a snopes article called "Getting the Lead Out." And in case you  
get an email claiming candles are a lead hazard, this talks about the facts regarding any emails you might get that are  
circulating out there. So Snopes' "Getting the Lead Out" and that's in the show notes as well.

Okay so let's move away from wicks which pretty much if you have a post-2003 candle should be safe. Now what about  
emissions from the candles themselves? Well for that I thought I would turn to the EPA. The Environmental Protection  
Agency and see what they have to say about this. And you know it's our tax money at work. Well the EPA does have a  
report on candles and incense and this was based on market analysis and a literature review of studies involving candles  
and this was all put together in 2001.


And I'm going to read the quote from this report. Don't worry it's not too long and it's not bland. So this is from EPA report  
which was in 2001 and which has not been updated to my knowledge as of the day of recording this show. The quote is,  
"With regard to the candles, consumers are exposed to concentrations of organic chemicals such as formaldehyde, acid  
aldehyde and acrolein. One study showed worst case scenario, candle emissions containing levels of these 3 chemicals  
that exceeded EPA recommended thresholds. But other studies indicated no health hazards. Sooting can occur when  
combustion conditions are impaired when burning candles. Scented candles are more likely to produce soot than  
unscented candles. Sooting can cause property damage by blackening surfaces although soot particles are very small  
and can potentially penetrate the deepest areas of the lungs, studies regarding potential human health effects associated  
with soot from candles were not found in the literature search. "
& 0:33:20

So the EPA is not calling this a major problem. Actually most of the bad press that I've seen on candle emissions come  
from website trying to stir you away from paraffin candles and instead convince you to buy their products which are soy  
and other vegetable derived waxed candles.

But are their assertions correct, that candle emissions are dangerous? Are the chemicals omitted from paraffin candles  
really harmful? Well unfortunately there just aren't good studies out there looking at this. And those who claim that paraffin  
based candles are dangerous almost on every one of their sites is, there's a quote that basically says the "American  
Lung Association warns of the danger that candle emissions." It's almost like viral advertising like all of these websites  
that wants to sell you soy and other vegetable based wax candles, they all say the "American Lung Association" says  
candles are dangerous.


And so this sort of statement is really, really common among all of these sites that are trying to sell you their alternative  
candles. But the funny thing is if you go to the American Lung Association website you can't find that anywhere. You can't  
find the statement about candles anywhere on the American Lung Association website. In fact the only thing remotely  
incriminating that I could find in doing an extensive search for this was from the Washington Chapter of the American  
Lung Association which you know it's one state's chapter, it's not the big organization so right there it's misleading  
because this place has claimed this is the American Lung Association when really just the Washington chapter.


And so what did they say, well and there's a link to this too candle info from the Washington chapter of the American Lung  
Association there's a link to that on the show notes. They said, "The scientific evidence linking burning of candles, the  
specific health effects is not conclusive. Some recent studies however suggest that burning candles contribute to fine  
particle pollution." So they recommend to keep your candle wick strand to less than one quarter inch to minimize sooting  
and to keep candles away from drafty places, use a good filtration system on your furnace, and replace filters more often  
during periods of high candle use.

Okay folks this is hardly a cry to arms by the American Lung Association to ban candles from your home as those selling  
their alternative products would have you believe. So let's synthesize all this. First I would say don't use lead core wicks. I  
mean there shouldn't be any new candles out there with them. But you know and you can be assured that least Yankee  
candle doesn't use lead core wicks. And whatever candles you get, I would just make sure they don't have lead core  


If you have candles that are more than a few years old and you aren't sure of the wick's composition, I wouldn't use it. I  
would get candles and burn them that you know do not have lead in the wick. Certainly candles released chemicals into the  
air you know from the candle itself whether it's a paraffin candle or soy candle I mean there's going to be emissions of  
chemical into the air regardless of what kind of candle it is.

We don't know if those chemicals are truly hazardous. The verdict is still out on that. Candles certainly can have soot  
issues which can lead to property damage and there are flesh burn and fire dangers associated with candles. But  
candles also provide a psychological benefit. I mean you got the warm glow, you know the flickering light, the aroma  
therapy. I mean there's something about candles that warms the soul for many people. So in the end we might take it as  
one of common sense. If you get enjoyment from candles, use them.


But use your head. You know I wouldn't light 20 of them in the same room that your baby's in, and I wouldn't light 20 of  
them in the same room that I'm in. And I wouldn't use old candles with lead core wicks. I wouldn't place a candle in a place  
or kids can burn themselves or knock it over and start a fire. And I would keep the wick trimmed to reduce scooting.

In the process you know I'll be exposed to what probably amounts to a trace of unwanted chemicals. Now isn't that enough  
to hurt me? Maybe, but if so, I personally think that it is a miniscule risk for adults and children and babies alike. Look we  
can't cover ourselves with bubble wrap and expect to go on living forever. In the process of doing our best to stay healthy,  
we also have to live.

And for some of us maybe even many of us living as a little sweeter with a candle or two around. Anyway that's my 2  
cents. Hope it helps. We'll take a break and we'll wrap up the show right after this.



All right thanks go out as always to Nationwide Children's Hospital for providing the bandwidth for our program. Also  
Medical News Today for helping out with the news department and of course to Vlad at Make sure you  
check him out. He provides the art work for the website and the feed. And of course big, big thanks to all of you for taking  
some time out of your day in joining us in contributing to the program here at PediaCast.


I know you've had those days when you're just sick of being a grown up so stop by the Pediascribe blog and  
commiserate with Karen. I'm sure she'd really appreciate that. She had a bad week last week. Weather is bad. Lots and  
lots of water and rain, and leaks in the house and you know how it is. So stop by the blog. Give her some love and there'll  
be a link in the show notes. Please do that because it'll make my wife easier at home. Okay.

All right don't forget the PediaCast shop is open. We do have T-shirts available for you. Please consider getting one of  
those and take it with you on vacation. It helps spread the word about the program and strike up a conversation with  
people around you.


You know, you know how this on vacation and you meet new people and that's always fun. And then I had mentioned  
before if you go some place easily recognizable please get a picture of your family with T-shirts on. We'll put it on the  
show notes up on the website. And in the fall we'll take all those draw one person who submitted it at random and give  
you $100 gift certificate. So think about that during the summer.

iTunes reviews are very, very helpful. We definitely appreciate those. And the poster page has PDFs that you can print  
out and hang up on bulletin board all over the place to help spread the word about the show. My Listener Rant and Rave  
show is almost done so hopefully that would be coming your way later this week plus we're going to catch up on Skype  
calls as well. So we'll see you soon and until then this is Dr. Mike saying stay safe, stay healthy and stay involved with your  
kids. So long everybody.


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