Whole Grapes, Autism, Marijuana Smoke – PediaCast 366

Show Notes


  • Join Dr Mike in the PediaCast Studio for another round of pediatric news! This week we consider the danger of whole grapes, fasting as a cancer treatment, a cause of autism, reducing the pain of baby shots, a hearing test to diagnose concussion and consideration of second-hand marijuana smoke.


  • The Danger of Whole Grapes
  • Fasting as Cancer Treatment
  • A Cause of Autism
  • Reducing Pain of Baby Shots
  • Hearing Test for Concussion
  • Second-Hand Marijuana Smoke


Announcer 1: This is PediaCast.

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello everyone, and welcome once again to PediaCast. It's a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. 

It is Episode 366 for January 18th, 2017. We're calling this one "Whole Grapes, Autism, and Marijuana Smoke." I want to welcome everyone to the program.  

So, my cold persists, so if I cough a few times, you'll understand why. I was actually giving over the other one . I had like two to three days of really feeling good, the cough was gone. And then, along comes another one. 

So, if you're out there with the kid at home who just seems to be sick all winter long, that's pretty much been me since right after Christmas. So, it happens, it happens to all of us. And you know, you one virus after another, and each one can last 10 to 14 days sometimes. So, can definitely prolonged the battle. Not just for kids, but for healthcare providers and probably for lots of moms and dads, too.   

As you can tell by today's title, I have a smorgasbord of pediatric news topic for you this week. And it's not limited to grapes and autism and marijuana. We'll also be going to talk about a reducing or maybe even eliminating the pain associated with infant vaccines. 
Also, fasting as a cancer treatment — could not eating help treat cancer? Also, a hearing test to diagnose and help manage concussion. And I wouldn't have thought that those two things would be related. Hearing tests and concussion, but they are, and we'll explain exactly how and why. 


So, lots of interesting material for you this week. I'll introduce the topics in a bit more detail in a couple of minutes. First though, I need more questions from all of you. So our last episode, I ran through a whole bunch of questions from the audience and now I need more to choose from. So if you have a pediatric question for me, it could be medical question, about a disease or treatment or some preventive measure. It could be a parenting question. Those are great, too. Or you may have a question about a news story you heard or a journal article you read, a discussion on your go-to social media site. You know, something that's in the news you just want to know more about. 
Whatever it is, it could even be something you thought might be a little silly to ask. Think no more. There are no silly questions around here. Just go ahead and head over to PediaCast.org and click on the Contact page and ask away. 

You know, maybe it's something that has had you baffled. Maybe it's something controversial . We don't avoid controversy here on PediaCast especially if an audience member brings it up. Whatever it is, I'd love to research your question. The reason I research it is because I don't know everything about everything. But I do know where to look to get a good evidence-based answer. 

And so, that's what we promise you, is that we'll try our best to keep it as evidence-based as possible. So that's there's real… It's not just anecdotal. It's not just, "Well, we think this happens because of observation." But there really is a bit research done on it. We will look for that.

Sometimes there's not. And we have to use our past experiences to make some decisions. And then, hopefully, we put a practical spin on it for you and share it with you. And then your fellow audience members can also take advantage of the fact that you asked the question because there's probably many of them who had a similar question as well and would benefit from the answer and, hopefully, the practical spin that we put on it for you.


Again, it's super easy to ask your question or leave your comments. Simply head over the PediaCast.org, look for the Contact link at the top of the page and ask away. I look forward to hearing from you.

All right, let's go into a little bit more detail about what we're talking about today with a little bit more context behind the episode's title. The danger of whole grapes — so, grapes you may not have thought of grapes as particularly dangerous. But they can be dangerous especially when they are eaten whole. 

So what is it that makes whole grape dangerous? Given that many kids out there like to eat grapes and given that grapes can be a healthy nutritious part of a balance diet, how can we make them safe? And how exactly is it that they're dangerous? So, it's a good question and I have the answer covered up.

And then fasting as a cancer treatment — now, we're not talking all cancers, just a specific one but it happens to be the most common of all childhood cancers, acute lymphoblastic leukemia (also known as ALL). Could schedule a fasting — so, not eating for a day — could save their lives? We'll take a look.

And then, a cause of autism, so you hear this frequently. And it's a good thing for parents to hear. Immunization do not cause autism, we know that. There's plenty of evidence to support that immunization, in particular the MMR, does not cause autism. Fine. So does what cause autism? 

Well, another frequent thing you hear is that autism is rooted in genetics. But that sort of simplifies things. You know, what is happening at the cellular, in the tissue level? What exactly is going on behind the scenes of those genetic abnormalities? Researchers are beginning to piece together some answers which are not only interesting but could someday really make an impact on autism treatment. 


So, stay tune for those details. It gets a little science-y but I'll do my best to break it down and explain as we go. 

And then, reducing the pain of baby shots, one of the complaints that many parents had about vaccines is the number of pokes it takes to get them all in even in line of the many combination products that are available. There's a lot of shots especially in the first year of life and they are all important. We know that there's no danger in giving the many shots but it is painful. Shots hurt and the babies cry and parents don't like it. 

Now, in my opinion that's not a reason in and of itself to forgo shots or alter the schedule. They're too important for that. But could we help babies be more comfortable during the vaccine experience? A group of researchers set out to find an answer to that question and I'll share their results. And then, we're also going to talk about, as I mentioned, the hearing test for concussion. Yes, you heard me right — a hearing test for concussion.

Preliminary research suggests that we may be able accurately diagnose concussions with the hearing test, and we can tell when the concussion has resolved by following that same test. This is a story that could change the way we diagnose concussions at some point. And you could do it right at the point of play or the point of injury, on the field, in the arena. So stay tune for the details. 

Finally, the second hand marijuana smoke. So, I'm not talking about the person actually smoking marijuana. This is just the person who's in the room with the smoker and you breathe a little bit of the smoke. Does the active psychotropic chemical — so the euphoric-inducing chemical, THC, in marijuana — does that enter your body in measurable amounts from second-hand smoke? 

And what if I'm a kid in the same room as a marijuana smoker? Which is happening with the increased frequency particularly in states where the recreational use of marijuana has been legalized. So the question is, does marijuana (and in particular THC) get into baby and toddler and young child bodies simply by breathing in little second-hand marijuana smoke? And what affect does it have on developing brain cells? 

So we'll consider these questions toward the end of today's program.


Before we get started, I do want to remind you the information presented in every episode of PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So, if you have a concern about your child's health, be sure to 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 PediaCast.org. 

Let's take a quick break. And, I will be back to talk more about whole grapes, autism, and marijuana smoke along with those other topics I mentioned. It's all coming up right after this. 

Dr. Mike Patrick: Very young children can choke to death on whole grapes. This, according to doctors at Royal Aberdeen Children's Hospital in Scotland and reported in The Archives of Disease in Childhood. Food particles account for over half of choking episodes among children under five years of age, with grapes ranking as the third most common culprit, taking their place behind hotdogs at number one and pieces of candy at number two. 

Despite the frequency of potentially lethal grape encounters, public awareness of the danger is low. The authors of the article would like to raise awareness by sharing three recent emergency cases involving whole grapes. 


Case number one involved a five-year-old who started choking while eating whole grapes at an after-school club. Prompt and appropriate attempts to dislodge the grape such as the Heimlich manuever did not work and the child went into cardiac arrest. The grape was later removed by paramedics, using special equipment but the intervention occurred too late and the child died.

Case number two tells a story of a 17-month-old boy who was eating sandwiches and fruit with his family at home when he choked on a grape. Attempts to dislodge it were again unsuccessful and his parents called for an emergency services. The grape was eventually removed by a paramedic but, again, the child did not recover.

Case number three has a happier ending but a very long trial to get there. This one involved a two-year-old toddler who was snacking on grapes in the park when he started choking. Again, the grape proved impossible to dislodge and an ambulance was called. This time Paramedics arrived on the scene within a minute and successfully cleared the airway. However, the child suffered two seizures before reaching the hospital and, on arrival, required emergency treatment to relieve swelling of his brain and the interventions to remove a build-up of watery fluid in his lungs. He spent five days in the intensive care unit but did end up making a full recovery. 

So, what is it that makes grapes so dangerous? And why are young children at greatest risk? Well, keep in mind the airways of young children are small. These children don't have the full set of teeth to chew food properly and their swallow reflex is underdeveloped. And they're easily distracted, all of which puts them at an increased risk of choking.

So what's the deal specifically with grapes? Well, grapes tend to be larger than the young child's airway. So you'd think they'd be kind of safe. But unlike small hard objects such as nuts, the smooth soft surface of a grape enables it to compress and form a tight seal inside the child's airway, not only blocking it completely but also making it difficult to remove without special equipment. 


Drs. Jamie Cooper and Amy Lumsden, co-authors at the article and pediatricians at Royal Aberdeen Children's say, "There is general awareness of the need to supervise young children when they're eating and to get small solid objects and some foods such as nuts promptly out of the mouths of small children. But knowledge of the dangers posed by grapes and other similar foods is not widespread." 

And while there are plenty of warnings on the packaging of small toys about the potential choking hazard they represent, no such warnings are available on food, such as grapes and cherry tomatoes.

So what's a parent to do? After all, many kids love the taste of grapes. And as part of a healthy balanced diet, they can represent an important serving of fruit. Drs. Cooper and Lumsden say grapes and cherry tomatoes should be chopped in half and ideally quartered before being given to young children, especially five and under. And they strongly emphasize the importance of adult supervision of small children while they are eating.

So, parents, be sure to half and quarter those grapes in cherry tomatoes. Think about the size those quarters of food represent. That's how small you want to cut up hotdogs as well. You got to do more than just slice up the hotdog, really half and quarter the slices. That's the safest size for the airway. 

Again, sorry about my cold. 

Just how big is your child's airway? Look at the width of his or her pinky finger where it connects with the hand and that will give you a rough estimate. And you want those food particles cut smaller than that. So extra plump grapes, you may want to do more than quarter those, cutting them into eights, maybe even [an order because if you cut them in half and quarter when the size is still bigger than the base of their pinky finger, then that still could pose a problem. 

I love how the authors in their advice always, always supervise young children when they're eating. Be sure to take a first aid class  so you have some knowledge on the proper way to dislodge a choking object. 

And while you're acting to rescue a child from choking, make sure somebody nearby is summoning emergency help. Here, in the USA, that means dialing 911. Of course, the digits in your area may be different if you're one of our international listeners. 


Intermittent fasting inhibits the development and progression of the most common type of childhood leukemia. This, according to researchers at the University of Texas Southwestern Medical Center as reported by the peer-reviewed journal, Nature Medicine.

This strategy was not effective, however, in another type of blood cancer that commonly strikes adults.

Dr. Alec Zhang, Associate Professor of Physiology at UT Southwestern and senior author of the study, says, "Our mouse models indicate the effect of fasting on blood cancers is type-dependent and they provides a platform for identifying new targets for leukemia treatment. We also identified the mechanism responsible for the differing response to the fasting treatment."

Investigators found that fasting or not eating for a day both inhibits the initiation and reverses the progression of two subtypes of acute lymphoblastic leukemia or ALL, B-cell ALL and T-cell ALL. The same method did not work with acute myeloid leukemia known as a AML, the type more common in adults.

Dr. Zhang says ALL is the most common type of leukemia found in children and can occur at any age. Current ALL treatments are effective about 90% of the time in children, but far less often in adults.


The two types of leukemia, ALL and AML, arise from different bone marrow-derived blood cells. ALL affects B-cells and T-cells, two types of the immune system disease-fighting white blood cells, while AML targets other types of white blood cells such as macrophages, granulocytes, and a few others. 

In both ALL and AML, the cancerous cells remain immature yet proliferate uncontrollably. Those cells fail to work well and displace healthy blood cells, leading to anemia and infection. They may also infiltrate into tissues and cause additional problems.

Researchers created several mouse models of acute leukemia and tried various dietary restriction plans. They used green or yellow fluorescent proteins to mark the cancer cells, so they could trace them and determine if their levels rose or fell in response to the fasting treatment.

Dr. Zhang says, "Strikingly, we found that in models of ALL, a regimen consisting of six cycles of one day of fasting followed by one day of feeding completely inhibited cancer development." At the end of seven weeks, the fasted mice had virtually no detectible cancerous cells compared to an average of nearly 68% of cells found to be cancerous in the non-fasted mice. 

Compared to mice that ate normally, the rodents on alternate-day fasting had dramatic reductions in the percentage of cancerous cells in the bone marrow and the blood filtering spleen as well as reduced numbers of white blood cells totally.

Following the fasting treatment, the spleens and lymph nodes in the fasted ALL model mice were similar in size to those in normal mice. Although initially cancerous, the few fluorescent cells that remained in the fasted mice after seven weeks appeared to behave like normal cells. 

Dr. Zhang adds, "Mice in the ALL model group that ate normally died within 59 days, while 75% of the fasted mice survived more than 120 days without signs of leukemia."


Fasting is known to reduce the level of leptin, a cell-signaling molecule created by fat tissue. Previous studies have shown weakened activity by leptin receptors in human patients with ALL. For those reasons, the researchers studied both leptin levels and leptin receptors in the mouse models.

They found that mice with ALL showed reduced leptin receptor activity. However, the leptin receptor activity increased with intermittent fasting.

Dr. Zhang says,"We found that fasting decreased the levels of leptin circulating in the bloodstream and decreased the leptin levels in bone marrow. These effects became more pronounced with repeated cycles of fasting. After fasting, the rate at which the leptin levels recovered seemed to correspond to the rate at which the cancerous ALL cells were cleared from the blood."

Interestingly, AML was associated with higher levels of leptin receptors that were unaffected by fasting, which could help explain why the fasting treatment was ineffective against that form of leukemia. It also suggests a mechanism — the leptin receptor pathway — by which fasting exerts its positive effect, the healing effect on ALL.

He adds, "It will be important to determine whether ALL cells can become resistant to the effects of fasting. It will also be interesting to investigate whether we can find alternative ways that mimic fasting to block ALL development."

Given that the study did not involve drug treatments, just fasting, researchers are discussing with clinicians whether the tested regimen might be able to move forward quickly to human clinical trials.

So, really interesting stuff here. Not quite ready for primetime. We need to see if the findings hold true in humans with ALL. But fasting as a cancer treatment, definitely a novel approach after this particular cancer, ALL. And one that may end up saving more lives in the future. Stay tune to PediaCast for further developments as they are discovered.


As many as one-third of autism cases could be explained by low levels of a single protein in the brain. This according to researchers at the University of Toronto and reported in the journal, Molecular Cell. The findings provide a unique opportunity to develop treatments for disorder that is rooted in a motley crew of genetic faults.

Researchers were able to induce autistic-like behavior in mice by lowering the levels of a protein called nSR100 (also known as SRRM4), which is important for normal brain development. The study builds on the teams' previous work which showed that the nSR100 protein was reduced in the brains of those with autism.

The teams were led by Professors Benjamin Blencowe of the University of Toronto's Donnelly Center and Sabine Cordes of the Department of Molecular Genetics and Sinai Health System's Lunenfeld-Tanenbaum Research Institute.

Dr. Cordes says, "We previously reported an association between nSR100 protein levels and autism. But this time we show that reduced levels of this protein could really be causative — that's a big deal. Just by reducing the nSR100 levels by 50%, we observed hallmarks of autistic behavior."

The data also suggest that nSR100 acts as a hub that channels diverse molecular miscues which contribute to autism.

Known best for altered social behaviors, the degree of which can vary tremendously, autism is a common neurological disorder affecting more than one per cent of the population. While its origins are genetic, the specific causes are known in only a fraction of cases that fall into the autism spectrum disorder (ASD). For the majority of people diagnosed with autism spectrum disorder, the reasons behind their disorder remain unknown.

The University of Toronto study provides evidence for the sweeping influence that nSR100 protein has on social behavior and other features of autism. 

In the brain, nSR100 acts as a key regulator of alternative splicing — a process that generates a remarkable diversity of proteins, which represents the building blocks of cells.


Proteins are encoded in the DNA sequence of the genes, but the useful instructions are broken up and separated by non-coding DNA. During alternative splicing, non-coding spacers are spliced out and protein-coding segments are brought together to make a finished protein template. But the order in which the coding instructions are stitched together can change so that a single gene can spawn a variety of proteins. This way, cells can expand their protein toolbox to vastly outstrip the number of genes. 

It's no surprise then that alternative splicing is especially pronounced in the brain, where the mushrooming protein diversity is thought to be the driving force behind the brain's astonishing complexity.

Blencowe's team previously discovered nSR100 and had shown that it is diminished in the brains of many autistic people. This finding suggested that autism could, in part, stem from an accumulation of incorrectly spliced proteins in brain cells. This could then lead to mistakes in brain wiring and autistic behavior further down the road.

This time, the teams decided to test head on if low levels of nSR100 can really cause autism. To do this, the team created a mutant mouse that lack nSR100 protein in order to study its behavior.

So what did they found? Well, researchers were amazed that reducing nSR100 protein levels… Let me pause here a minute. So these mice have no nSR100 protein that they're making on their own. So the researchers can then give them nSR100 protein at various levels to sort of mimic what would normally be a 100% versus what would be 50%. 

The researchers were amazed that reducing nSR100 levels only by half, giving these mice half of what they normally would make on their own, was enough to trigger the behavioral hallmarks of autism, including avoidance of social interactions and heightened sensitivity to noise. The nSR100 mutant mice also shared many other features of autism with human patients, such as changes in alternative splicing and brain wiring.


The team also worked with investigators in Barcelona, to show that nSR100 levels are linked to neuronal activity. The researchers say if you have an increase in neuronal activity, which is the case in many forms of autism, the nSR100-controlled alternative splicing program is disrupted, and this likely underlies autistic behavior.

Dr. Blencowe adds, "A major value of the nSR100 deficient mouse is that it can explain other causes of autism and how they impact neurobiology by converging on the nSR100 protein. Our mouse model will also serve as a useful testing ground for small molecules that have potential to reverse nSR100 deficiency in autism."

And Dr. Cordes points out, "Instead of focusing on individual mutations linked to autism, it's much more powerful to identify regulatory hubs like the nSR100 protein. In the future, if you turn this protein up a little bit in autistic patients, you might be able to improve some of the behavioral deficits." 'Might' being a keyword there.

So, these are exciting times in autism research as we begin to learn more about true cause of autism. There's certainly more work to be done, more discoveries to be made and treatments to be tested. But stay tune to PediaCast and we'll continue to keep you up to date of the latest developments.   



Dr. Mike Patrick: For babies under one year of age, lidocaine cream, combined with a small amount of sugar given by mouth and infant soothing, can help relieve pain from routine vaccinations. This according to researchers at The Hospital for Sick Children, the University of Toronto, and York University and published in the Canadian Medical Association Journal.

Dr. Anna Taddio, professor of Pharmacy and one of the study authors says, "Vaccinations cause acute distress for both infants and their parents, contributing to vaccine avoidance. However, there are gaps in knowledge about what is the best way to alleviate pain during vaccination."

To address this gap, researchers conducted a randomized controlled trial involving 352 healthy infants from 3 pediatric outpatient clinics, including 7 physician practices, prior to starting their schedule of vaccinations in their first year of life. 

The infants were randomized in to one of four groups — the placebo control group which just got their shots like normal, a group which receives video instruction for parents on how to soothe their baby, another group with a video plus oral sugar solution, and then finally, a fourth group who saw the video, had the oral sugar solution and had lidocaine cream applied to the skin at the shot site prior to receiving the vaccination.

Dr. Taddio says, "We found that when used consistently during vaccine injections in the first year of life, only the topical lidocaine combined with parental video instruction and orally administered sugar or sucrose, that was the only combination that showed a benefit on acute pain when compared with placebo, video alone, and video and sugar together."

The authors conclude by saying the effects of consistent pain management on the reduction of pre-procedural anxiety or fear, hypersensitivity to pain, and compliance with future vaccination warrant further investigation.


So don't expect these measures to be present quite yet at your local pediatrician's office. This reducing pain really improve overall vaccination rates. Certainly, we want babies to be comfortable but also does it really improve overall vaccination rates. That remains to be seen. 
Will the cost be covered? You know, will insurance companies cover the cost of the lidocaine for everybody? Is there enough supply? Are the manufacturers ready to actually use the topical lidocaine across the spectrum of practices. Imagine, you're going to make, you're going to use a lot of it. And so can we keep up with supply and who's going to cover the cost? All questions that would need to be answered. 

And the other thing, is the widespread and recurrent use of lidocaine cream safe in babies? So we do use topical lidocaine cream in older kids when we do stitches. Sometimes, we use it to numb the skin before stitches or before IV placement. But these are typically older kids. So what if we do it to two month olds and you do it again at four months, and again at six months? Is there a safety factor that would have to a establish that it's safe? 

So, we have more questions to answer, few more studies to be done. But in the future pain control for vaccines could become commonplace. Time will certainly tell.

The secret to reliably diagnosing concussions may lie in the brain's ability to process sound. This, according to researchers from Northwestern University's Auditory Neuroscience Laboratory and published in the journal, Nature – Scientific Reports.

Concussions are common. Some even consider them a crisis in professional sports and youth athletic programs. Sports-related concussions can have significant neurological, physical, social, and emotional consequences for millions of athletes. Still, no single test has been developed to reliably and objectively diagnose concussions, until now.


Dr. Nina Kraus, professor of Neurobiology and Physiology in the Department of Communication Sciences and Disorders at Northwestern University and director of the Auditory Neuroscience Laboratory, and lead author of the paper, says, "Our groundbreaking research has found a biological marker in the auditory system that could take the ambiguity and controversy out of diagnosing concussions and tracking recovery."

She adds, "This biomarker could take the guesswork out of concussion diagnosis and management. Our hope is this discovery will enable clinicians, parents and coaches to better manage athlete health, because playing sports is one of the best things you can do."

Okay, so what is this biomarker and how did the research team test it? 

Well, they begin by placing three sensors on the heads of children to measure brain activity while the kids were exposed to a specific sound. So they put this electrodes on, they play a sound, the brains responds to that sound and they measure that response with the electrodes. 

What they found was a distinct pattern in the electrical auditory response in the brains of children who suffered concussion compared with children who had not. By measuring the brains electrical response to the sound, they were able to successfully identify 90% of children with known concussions and 95% of children in the control group who did not have a concussion.

Children who sustained concussions had on average a 35% smaller neural response to pitch, allowing the scientists to devise a reliable signature profile. And as the children recovered from their head injuries, the process of pitch returned to normal.

Dr. Kraus says, "Making sense of sound requires the brain to perform some of the most computationally complex jobs it's capable of, which is why it's not surprising that a blow to the head would disrupt this delicate machinery. What was surprising was the specificity of the findings. This isn't a global disruption of sound processing. It's more like turning down a single knob on a mixing board."


Now, this was a small study consisted of 40 children with known concussion and another 40 in a non-concussed control group. But Dr. Kraus said this is a major first step.
Dr. Cynthia LaBella, Director of the Institute of Sports Medicine at the Ann & Robert H. Lurie Children's Hospital of Chicago and professor of Pediatrics at Northwestern University Feinberg School of Medicine, and co-author of the paper says, "Our ambition is to produce a reliable, objective, portable, user-friendly, readily available and affordable platform to diagnose concussion."

Dr. Kraus adds, "With this new biomarker, we are measuring the brain's default state for processing sound and how that has changed as a result of the head injury. This is something patients cannot misreport. You can't fake it or will your brain to perform better or worse."

So more interesting stuff from the world of pediatric research. Could a little box with electrode attached to a kid's head quickly and reliably diagnose concussion on a playing field or sports arena? And could that same box let you know when the concussion has resolve?

Time will tell. And you can say you heard about it here first on PediaCast.

Children exposed to second-hand marijuana smoke show measurable amounts of the drug in their bodies. This according to researchers at the Icahn School of Medicine at Mount Sinai and published in the journal Pediatric Research. The study found that when young children are exposed to second-hand marijuana smoke, measurable amounts of the primary metabolite of the active component in the psychoactive chemical, tetrahydrocannabinol (or THC) appears in the samples of the children's urine. 

Because earlier analytical methods were developed to measure biomarkers of marijuana in primary users of the drug, a new, more sensitive analytic method was developed and used by the US Centers for Disease Control and Prevention, or CDC, to quantify the trace biomarkers resulting from second-hand marijuana smoke exposure.


Dr. Karen Wilson, Chief of General Pediatrics, and the Vice-Chair for Clinical and Translational Research for the Department of Pediatrics at the Icahn School of Medicine at Mount Sinai says, "This shows that like tobacco smoke, marijuana smoke is inhaled by children in the presence of adults who are using it. And in areas where marijuana use is legal, or common, education is needed to counsel parents on the dangers posed to their children by second-hand marijuana smoke."

For the study, urine samples were collected from 43 babies between the ages of one month and two years who were hospitalized in Colorado with bronchiolitis. So they were just hospitalized for a respiratory illness and the researchers collected their urine to test for presence of marijuana exposure. 

Of course, the parents were on board with this and there is permission granted. And they were asked to complete a survey about their marijuana smoking habits. The samples were analyzed, and the levels of biomarkers for a specific marijuana metabolite were recorded. 

Now, let me pause here for a moment. You may be asking yourself what is a marijuana metabolite? Unless the babies were just exposed to marijuana smoke, you're probably not going to find THC, the euphoric-conducing chemical in marijuana. You're probably not going to find that in their system because the body breaks it down and these breakdown products are referred to as metabolites. 

Now, one metabolite in particular hangs around for a long time and has no business otherwise being in a baby's body unless he or she had been breathing marijuana smoke at some point in the not too distant past. So levels of this specific metabolite, so one of the chemicals that results from the body breaking down THC — note the COOH-THC — these were analyzed in the urine of these 43 babies and toddlers who'd been hospitalized for bronchialitis or respiratory illness. 


As it turns out, that metabolites, COOH-THC, was detectable in 16% of the samples in concentrations between .04 and 1.5 nanograms per milliliter of urine, which is lower than would be seen in the primary user. But this percentage was consistent with the number of parents who self-reported marijuana use in the survey.

Dr. Wilson says, "Parent reported screening questions in areas where marijuana is legal. It's a helpful first step. While we do not yet know whether this exposure poses a health risk to children, this study highlights the urgency of further investigation." 

So, definitely something to think about. If you live in a location where the recreational use of marijuana is legal — and even if it's not legal but you recreate with it anyway, this applies to you as well — please don't smoke marijuana around your kids. Please. 

Now, we don't know the exact nature of its effect in second-hand smoke at this point. But won't you rather be safe and sorry till we do know? And besides the second-hand smoke issue, you want your faculties to remain intact as you care for and safeguard your little ones, right?  

The issue with this particular study is not whether the marijuana has an effect on your kids. It may or may not, that's to be determined.  But they are inhaling and they are getting THC inside their bodies when you smoke around them. 

Parenting is an important job, and we shouldn't be under the influence of marijuana or alcohol or any other recreational drug as we guide our most cherished possessions through life. There's just too much at stake. 



Dr. Mike Patrick: All right, we are back with just enough time to say thanks to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that.

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You'll find the contact page up at the top. If you head to PediaCast.org, just look at the top. It will say Contact Dr. Mike, click that, and send away. 

We're also on social media, on Facebook, Twitter, Google+ and Pinterest. Really appreciate you following us there and sharing our content with your friends and followers. Really helps to get the word out and spread the news about PediaCast.  


Of course, word of mouth also helps. So be sure to tell your family, friends, neighbors, co-workers, babysitters, day care workers, grandparents, really anyone who either has kids or takes care of kids, including teenagers and college students. We really appreciate you telling them about the program.

And especially your child's doctor because if they can share it with all their other families and patients, and boy, that really helps to get the word out. Just let them know that you found an evidence-based pediatric podcast for moms and dads. And they can find it easily at PediaCast.org and all the other places we just talked about. 

Also, let them know we have a program for them, PediaCast CME. That stands for Continuing Medical Education. Similar to this program but we turn the science up a couple of notches and offer a free Category 1 CME Credit for those who listen. Shows and details are available at PediaCastCME.org.  

Thanks again for stopping by, and until next time, this is Dr. Mike, saying stay safe, stay healthy, and stay involved with your kids. So long, everybody. 


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

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