This post is part of the May evidence-based parenting blog carnival. Check out the main post at School of Smock here, and I will updating this post with links to the other posts.

Here’s a list of things that did not happen when I had my son in June 2010:

• Angels did not fly into my room singing
• Fireworks did not go popping out my window
• The earth did not visibly tilt on its axis, or stop in its rotation
• No nearby Richter scale needles jumped even the slightest

And you know what else? My husband and I did not weep tears of joy and love, and I did not fall madly in love with the creature in my arms, suddenly realizing in a flash that my entire world had changed. In fact, he wasn’t even in my arms. He was clumsily placed beside my head in a tightly wrapped bundle, while I was still waiting for the placenta to make its exit (it never did – I required emergency surgical intervention for the doctor to manually remove it). I looked at him and thought, “Huh! He’s actually a little cute-ish. Not scrunched up and weird like most newborns. Cool.” And then someone asked me if I was tired, and I said, “F*** yeah!” and everyone laughed. One moment there had been a cantaloupe-sized head lodged in my vagina while I impatiently waited for the doctor, and the next, there was the grating, tinny cry of a newborn in the room, and nothing else was really different.

Because of my surgery, the next time I saw him was a number of hours later, after my shivering body had shed all the anesthesia and I was able to sit up. Although I had a vaginal delivery, I had lost a lot of blood and was on transfusion-watch if my body didn’t replenish itself quickly enough. I was wheeled to the nursery to breastfeed first thing, as I’d requested; he was being watched for low oxygen levels. And I remember it was kind of awkward and cool and whatever. I’m trying to figure out how to hold this little thing and get him to latch and feeling like a clumsy child learning gingerly learning a new skill..

And all of that was fine.

Hook 'em horns! After all, my husband and I were both attending UT when we had D.

What wasn’t fine was the guilt I experienced over the next few weeks when I realized that I was NOT madly in love with this strange, needy little critter. I thought he was cute. I enjoyed looking at him. I liked taking photos of him. I felt a (usually) unburdensome duty to care for him in every way possible. I wanted to soothe him. I was determined, hell or high water, to breastfeed him exclusively, no matter how excruciating it was (and it WAS excrcuiating for a variety of reasons). His crying frustrated and pierced me. But when I looked at him, I felt as I might about a new little puppy: a cute, clumsy, odd sort of creature who relied on me for everything. Boy, wasn’t I a horrible mother! I thought of my child as nothing more than a pet?!

Here’s the thing: I was normal. I am normal. And now, almost three years later, I’m utterly in love with my son and sometimes love just watching him as he tries to do something as ordinary as clipping and unclipping the cat collar in his little hands, working on those fine motor skills. If muses aren’t whispering love sonnets in your ears in the first hours or days after birth, that’s okay. Completely okay. Read the rest of this entry »

I will never forget my first night home with my new son after a few postpartum days in the hospital. Most likely haven’t or won’t forget their first night at home with the new baby, but in my case it’s marked by a level of frustration, helplessness and despair that likely could have been allayed slightly by the findings of a very small study published in Pediatrics today. I will describe the study and its findings shortly, but my own personal anecdote is telling when it comes to the possible implications of the study.

A new study calls into question whether early formula feeds actually hurts exclusive breastfeeding rates. Photo courtesy of Microsoft stock images.

It was after 2 am, and I was sitting in the middle of our bedroom floor, bawling, my body convulsing with my utter desperation and inadequacy, while my husband held our screaming son, who wanted nothing more than the most basic thing I was supposed to provide for him–food.

My milk had not yet come in, so only that liquid gold colostrum could be squeezed from my breasts, but in minuscule amounts that did not satiate my son. He had lost more than 5% of his body weight shortly after birth and had not regained it all yet. They nearly did not discharge him and there was talk of supplemental feeding with a tube-attached-to-nipple contraption that never quite worked and which made me uneasy nonetheless.

See, I had planned to exclusively breastfeed my son and NOTHING would get in my way. I had the irrational conviction that giving him formula was wrong, bad, awful, even though I cannot quite articulate why I felt that giving him even a little bit would have been such a bad thing. I was a little concerned about nipple confusion, but mainly I was concerned about making sure that nothing went into my son’s stomach but his mother’s milk.

The problem is that I had excruciating pain in my nipples from breastfeeding him. I literally was incapable of nursing him unless I was taking 800mg of Motrin, as directed by the hospital staff. Even then, I gritted my teeth, tightened my buttocks and braced myself for the first sixty seconds of his latch, drawing my breath in sharply and trying not to scream, until the pain subsided to bearable, but still aching, territory. I had seen several lactation consultants, and they were baffled. The latch was good. We never figured out what the problem was, but it took weeks for that pain to go away, even when I enjoyed nursing.

And now, in those wee hours of our first night home, I was completely wrung out and dried up. Just his lips touching my nipples felt like a dozen razor blades, and it was all for naught because I simply was not producing enough colostrum for him. Where was my damn milk?! On the counsel of my husband and my far calmer mother, a breastfeeding champion herself, I finally gave in and fed my son some of the pre-mixed formula the hospital had sent us home with. It was only an ounce, but I simultaneously felt relief and like a failure.

The next day, my milk came in. I never had to give him formula again. All was well. I exclusively breastfed until he was 5 months old, and I’m still, almost three years later, nursing him.

I am, therefore, the kind of “success story” described in the Pediatrics study that’s making waves across the lactation community today. As much as I am a breastfeeding advocate, I am not into the mommy-wars shaming of formula feeders, and I think the lactation community should be willing to consider the potential wisdom in this admittedly small study. Read the rest of this entry »

All right, folks, this will be a whirlwind of links, but if you missed any health or science news this week related to parenting, I’ve hopefully included it below.

First there’s been a bunch of news about ADHD, and none of it really that good. First, it’s hard to tell which is worse: that we are likely overdiagnosing ADHD or underdiagnosing the condition. That may sound contradictory, but it’s very possible that lots of kids are diagnosed with it when they shouldn’t be while swaths of other kids fly under the radar. For those who are appropriately diagnosed with ADHD, are they getting the right first-line treatments? Even though preschoolers diagnosed with the disorder should be treated first with behavioral therapy, and only with medication if behavioral therapy fails, many doctors aren’t following these clinical guidelines. I wonder if this over-willingness to treat even preschoolers with medication is linked in any way with concerning trends on the other side of childhood — college students. An analysis of tweets has shown that Adderall misuse and abuseis certainly common.

If you head to the amusement park this summer, look out for the little ones. Photo courtesy of Microsoft stock images.

From the not-so-great news to the good news: playing sports might help reduce the risk of being bullied or engaging in violent behavior in some teens, primarily girls and primarily those in team sports. Boys appear less affected by this trend, but they are affected by a different issue: an ignorance of how dangerous concussions can really be, or so it seems since so many football players seem to think it’s just fine to jump back in the game with a concussion. (Newsflash: it’s not.)

With summertime on the way, more and more families will probably be grilling in the backyard. Just be sure to keep kerosene and other hydrocarbons (methane, butane, propane, etc.) away from kids. Those under 5 are most at risk for poisonings from these common chemicals. Kids under 5 are also at higher risk for getting injured at amusement parks. Less than 2% end up hospitalized, but with over 4,000 injuries a year landing kids in the ER, make any trips to Six Flags or the carnival safe trips. Or, skip the amusement park and have the kids just play outside — apparently, it’s good for their eyes. Read the rest of this entry »

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I’m excited to write about the recent study on pacifier “cleaning” and allergy risk that came out in Pediatrics yesterday, but first I apologize for being MIA the past few weeks. A combination of work, family and travel converged to push this blog low on the to-do list, and now the catching up I have to do is daunting. So much to write about! But I’ll start small: with this small study about a small puzzle piece that might – might – fit with the larger idea of the hygiene hypothesis. And I’ll discuss one finding in it that most of the media (even the good NPR story) skipped over entirely.

Even though the study only came out yesterday, there’s been a lot of buzz already about the idea that parents who “clean” their kids’ pacifiers by popping them in their own mouths can reduce their children’s risk of allergies. (I had three people tag me on Facebook with it, so I’m regretting the fact that I didn’t write about it Sunday night as I’d planned and as my dailyRx story on it came out.)

Photo by T. Rolf.

As with so much health news that gets buzzing, the conclusion(s) in the popular media tend to be oversimplified and overhyped, but the actual study, from a couple Swedish researchers, is fascinating. We just need to keep a couple caveats in mind: first, the study is very small. Second, the associations found in the study are very small, and several disappeared as the kids grew older. Third, there are multiple possible mechanisms that could explain or contribute to the findings, so jumping to conclusions about what it “means” or what pacifier “cleaning” methods do or don’t “cause” is definitely premature.

First the study: the researchers recruited 184 women within a few days of giving birth to participate in the study if they gave birth at full term and their children did not receive neonatal intensive care. Most of the babies (80%) had at least one parent with allergies, which theoretically should have made the children more prone to allergies as well.

After an initial interview, the parents kept a diary of the babies’ first year of life, recording “food introduction, weaning, diseases, medications and other significant events.” The parents provided this info in a 6-month interview where they were also asked if their child used a pacifier (74% said they did) and whether it was “cleaned by boiling, rinsing in tap water or by the parents sucking on it?”

Let’s stop there for a moment. While the parents could choose more than one option here, that’s a really open question. When my son’s pacifier fell on the floor at a restaurant, sometimes I picked it up, popped it in my mouth and then popped it in his. Sometimes I dipped it in my ice water at the table and popped it in his. And sometimes I tossed it in my bag, later running it through the dishwasher. How would I answer that question? I guess all three? (But even answering all three hardly captures how often I did each of those, and whether my frequency of each made a difference. I very rarely put it in the dishwasher, I never boiled it, and I frequently “cleaned” it with my own mouth – or not at all.)

In any case, the answers were that 83 percent of the parents rinsed the pacifier with tap water, 54 percent boiled it, and 65 cleaned it by sucking on it themselves.

Next, the researchers took saliva samples from the kids at 4 months old (to investigate the bacteria makeup in them) and then assessed them for allergy symptoms when the kids were 18 months old and 3 years old. They looked for symptoms of asthma and eczema and then tested the kids’ sensitivity to a combination of food allergens (milk, egg, soy, fish, wheat and peanut) and another combination of environmental allergens: birch, timothy grass, mugwort, cat, dog, horse, mold and house dust mites.

Here’s what the researchers found: Read the rest of this entry »

So… last week was a bit of a doozy. My head is still spinning from the insanity of the Boston Marathon blasts, the explosion in West, Texas (a city I’m dearly familiar with), the poisoned letters sent to the president and a Congressman and then the exhaustive manhunt in Boston which came to a climactic resolution Friday evening.

I feel fortunate that my son is young enough still that the conversations about these events is not needed. But in only a year or two more, that will not longer be true. I’ve written before, after Newtown, about resources that help parents to discuss traumatic events with their children in age-appropriate ways. There is also an excellent discussion of these tough conversations on the Boston Traumablog of Boston Medical Center.

Some cheery cherry blossoms after a rough week. Photo from royalty-free Corbis.

The craziness of the past week, combined with some extra deadlines and events in my own life, have meant fewer blog posts in the past few weeks, and I hope to pick that up this upcoming week. For now, I’m going to include the round-up of health articles parents might have missed in the onslaught of news about more serious events.

A couple pieces focused on the littlest babies: Every extra week of pregnancy really does make a difference in later development as long as there is no medically indicated reason to induce birth earlier. And for those who are born early, an incredibly fascinating study looked at how different types of music (lullabies, heartbeats, breath sounds) improved preemies’ vital signs.

Another couple pieces looked at gestational diabetes. Apparently, eating a low carbohydrate diet may not change the likelihood that women with gestational diabetes will need insulin or not. And women with gestational diabetes or preeclampsia may be at a higher risk for diabetes later, though weight wasn’t taken into account in that study, limiting its usefulness, unfortunately.

For those unfortunate moms who have had babies with colic (or have children with migraines), you might want to check out this also intriguing study about a possible link between colic and childhood migraines. It’s very preliminary research, but I’m curious if any moms have seen this link in their children.

An unsurprising but still important study found, frustratingly, that parents rely more on their social networks for immunization decisions than they appear to rely on science. (That’s not exactly what the study found – it found social networks influence parents’ vaccination decisions – but that’s the upshot.)

For moms who breastfeed their children for longer periods, make sure your kiddo is getting enough iron. The risk of iron deficiency in breastfed kids isn’t exceptionally high, but it does exist.

A great piece by Yani Freedhoff that asks the provocative question: If you’ll die for your children, why won’t you cook for them?

Two pieces looking at substance use in teens finds that talking to your kids before they head off to college really does make a difference in their alcohol drinking choices, and teens are much more likely to smoke if family and friends smoke as well.

A general study on drinking enough water finds that – surprise! – many of us aren’t getting enough of that hydrogen dioxide.

Although this study did not look at circumcision in babies, I still found it interesting that the penis microbiome (the bacteria under the foreskin) changed following circumcision in men in an African study. It would be interesting to see studies on this in infants, even if randomization were not possible.

Finally, I want to link to this beautifully stirring piece by a young mother of three who is dying of breast cancer. It is deeply emotional – I cried and I can’t imagine how one could not – but it is also beautiful and important testament to the power of being alive and loving. It will remain with you.

Childhood obesity is one of those issues that isn’t going away any time soon, even if it seems as though we’ve already been hearing too much about it. Rates continue to climb throughout most of the US, with some notable exceptions, and public health officials, doctors, parents and schools continue to scramble to find causes and solutions. Even the military is concerned about future recruits if the trend continues.

Photo courtesy of Microsoft Images

But part of the problem may be that much of the public isn’t looking in the right places for reasons and solutions, or, quite possibly, doesn’t want to acknowledge or accept the reasons because of the solutions they lead to. Four studies in Pediatrics and one study in JAMA Pediatrics last week together point to a growing body of research about the reasons our kids are fat: it’s the world we live in, and nearly every aspect about it that’s different than a half century ago. I wrote about three of the Pediatrics studies in Scientific American last week, which has the best overall summary of them with some excellent commentary by Dr. Yoni Freedhoff, an obesity doctor who writes the highly recommended blog Weighty Matters. (I was thrilled to see the story picked up by Yahoo, Salon and Smithsonian’s blog.)

I also wrote about each of them for dailyRx. Each of them has limitations to their findings or methodology that should not be dismissed, but together, these studies and dozens of similar ones in the past several years make it clear that folks like Michael Bloomberg might be on to something with their “nanny state regulation.” Love him or hate him, there is evidence to back up his idea that reducing soda consumption can have an impact on kids’ (and adults’) waistlines. A study just a few weeks ago in the American Journal of Preventive Medicine found that kids who drink more sugary beverages also consume more calories – BESIDES the calories in the sugary drinks themselves. I wrote about the study in greater detail at dailyRx.

With kids’ meals’ sizes increasing (pdf) and evidence about the influence of sugary beverages, along with other findings discussed in my Scientific American article, it’s hard to ignore that we as a society are responsible for making our kids fat – and that’s even putting aside for the moment what “Big Food” has done or is doing to contribute to the problem.

Here’s a brief rundown of each of the five studies from last week, starting with the JAMA Pediatrics one (click on the links to read the details): Read the rest of this entry »

Here’s a brief round-up of a couple interesting stories from last week.

Video and computer games can offer kids some good – especially if they’re used to teach healthy behaviors, as this analysis of multiple studies reveals.

Photo by Christine Rondeau.

We already knew that secondhand smoke was bad for everyone, and especially kids. But there’s limited evidence that it may be linked to chronic kidney disease in kids too.

If you’re the parent of the more than 5 million IVF babies who have been born since Louise Brown joined the world in 1978, you can pay your respects to the man that made it happen. Robert Edwards passed away last week.

A tragic death in 2009 involved a 15-year-old girl who died of the chickenpox, according to a report by the CDC. Any child’s death is tragic, but this one struck me as particularly upsetting because chickenpox is now preventable with the vaccine, yet it’s one of those vaccines parents are less likely to think “necessary,” and the disease is one parents are more likely to think is relatively “harmless” (as chickenpox parties and infected lollipop mailings attest). And speaking of vaccine-preventable diseases, the measles outbreak in the UK right now is sad evidence of the effects of decreasing vaccination rates and weakened herd immunity.

Could your teen be at risk for heart disease later on? See if they already have some of the risk factors.

Not many children get long-lasting seizures, but for those who do, parents may worry about the child’s long-term prognosis. This study finds that some long-lasting seizures are linked to developmental problems, but it’s more likely that an underlying condition is contributing to the seizure and the developmental issues, rather than the seizure causing them.

And that’s all, folks!

I’m going to start a new routine for Fridays in which I round up a bunch of links to various health and science news I didn’t get to blog about. Much of it will be stories from dailyRx that I’ve written, but I’ll list other links as well, including fun ones to discuss with your kids. Today’s links, however, will be all health news ones. These are all for the week of March 31 to April 5.

First up is actually a study I will be blogging about later but haven’t had a chance to discuss yet. Either way, check out the details on why researchers have shown – again – that vaccines do not cause autism.

photo courtesy of Microsoft images.

A couple of stories on kids and nutrition/obesity: kids are still getting too much sugar and fat in their diets (duh – though I hate that they group together sugar and fat since the problems for each are very, very different), and kids who are obese are may be more likely to have low bone mineral density.

Also, researchers are still teasing out the specific practices with infant feeding that are linked to obesity in toddlerhood. (While they find several behaviors related to formula feeding, those are quite likely to be associated more with the socioeconomics of families who more commonly use formula and may not be associated with the formula itself. This is an ongoing debate that has yet to be settled.) For those who do formula feed, it’s still unclear whether prebiotics can help prevent allergies, though they supplements do appear to offer some protection against eczema.

For expecting moms, you don’t need to worry much about blood clots during or after pregnancy unless you have certain specific pre-existing conditions (even then, it’s rare, but you should make sure your doctor knows). However, more research has been published about the risks of being an overweight expecting mama. (I have a complicated relationship with these stories – the information is important, but I always worry about fear-mongering… but the information really IS important…)

For those with preschoolers, if your child exhibits symptoms of ADHD, you might want to look into parent behavior classes before looking for a prescription. Also keep in mind that behavioral issues in kids can result from poor breathing during sleep, such as heavy snoring and sleep apnea.

For those with teens, here are some recent stats on how many preteen and teen girls are sexually active, and for those who are, IUDs can serve a second purpose beyond birth control by helping with the pain from endometriosis – yes, even for teens. Another article looks at the kids and teens who are abusing substances to cope with a parent deployed abroad in the military.

And from the annals of “Seriously, woman, THINK OF THE CHILDREN for real!” comes this story about moms who continue to light up around their children, despite tons of research about the negative health effects of secondhand smoke.

And that’s all folks!

Today’s blog post is part of an evidence-based parenting “carnival” hosted by Science of Mom that I’m proud to participate in this month. Along with several other science-minded mom bloggers, I’m writing about preschool.

Discussions about the value of preschool have been in the news a lot lately, primarily because of the president’s discussion of “universal preschool” in the State of the Unionaddress nearly two months ago. Of course, this blog doesn’t deal with politics, and I have no interest in digging into the wonky details of a universal preschool policy and whether it would be financially feasible and/or achieve what the president expects it would.

What I do want to do is look at one recent study on the effects of a preschool program that was published last week in Child Development. There are hundreds of studies on preschool, but this will be a sort of case study for what kinds of things we might glean from such research. Bear with me a bit – it takes a while to describe the details.

The two-year study, by a couple of researchers at Harvard’s Graduate School of Education, grew out of the lead author’s dissertation and focused on the impact of a publicly-funded preschool program in Boston. The program included evidence-based curricula on literacy, language (called Opening the World of Learning) and math (called Building Blocks). About three quarters of the teachers had Master’s degrees and more than five years of teaching experience. In addition to curriculum training, the teachers had instructional coaches, all with Master’s degrees, to help them implement the curricula.

Photo courtesy of Microsoft Stock Images.

A group of 2,018 children who attended the preschool program as 4-year-olds in 2008-2009 were compared to their peers in kindergarten the following year. They comprised about 43 percent of the 2009-2010 kindergartener class, so the control group was a little larger than the preschool group. (I couldn’t find the actual number of control children in the study, but a little over half of the control chidlren had been in daycare or Head Start.)

During that fall of 2009 (mostly October and November), the kindergartners underwent a series of nine tests to assess their vocabulary, pre-reading and reading skills, numeracy and early math, executive functioning skills and emotional development. The combined tests took about 45-50 minutes to administer.

Without getting into the statistical nitty gritty, the researchers estimated the “effect” of the preschool program on the children who had attended the special preschool program and found “moderate-to-large” gains in language, literacy, numeracy and math skills. They found a small impact on the kids’ executive functioning and emotion recognition. Read the rest of this entry »

Among the newer vaccines added to the CDC immunization schedule in the past few decades is the chickenpox vaccine, licensed in 1995 and recommended in 1996. It’s also one of those vaccines that some parents today sometimes consider skipping, a handful even opting for the extreme (and dangerous) choice of taking their child to a chickenpox party or giving them chickenpox-infected candy in hopes of giving them the lifetime immunity so many of us got when we caught chickenpox as kids.

But there is no need to put your child through the misery – and risk of hospitalization or death– of the disease when a vaccine offers just as strong immunity without the pain and suffering. A new study reveals that the immunity offered by the vaccine is 90 percent effective and doesn’t lose its immunity over time.

Photo courtesy of Microsoft stock images.

The study, published in Pediatrics today, followed 7,585 kids who received the varicella (chickenpox) vaccine in 1995 when they were 2 years old. A little over a third of them (2,826 of the children) received a booster shot some time between 2006 and 2009. They were tracked for 14 years, through 2009, to for their rates of chickenpox and herpes zoster, commonly known as shingles.

The rate of chickenpox infection among these children was almost ten times lower than the rate among kids before the vaccine was available. An average rate of 16 kids out of every 1,000 caught the chickenpox each year in this group, and most of them experienced only a mild infection. Historically, somewhere between 140 and 160 children per 1,000 would be expected to catch the chickenpox each year in a group of kids this size.

No vaccine is 100 percent effective, but many diseases are often far milder in people who were vaccinated against them even if they become infected with the disease. The varicella vaccine, these researchers calculated, is about 90 percent effective at preventing chickenpox and doesn’t appear to wane, at least not over the 14 years of the study. Further, none of the children who received a second dose of the vaccine developed an infection afterward.

Most of the kids in this group who had chickenpox got it not long after they were vaccinated, which also would have been while more chickenpox was still circulating in the community. As more children are vaccinated and fewer catch the disease, “herd immunity” takes over and makes it less likely that kids will get infected.

Additionally, the researchers found that the rate of shingles in these children was lower than the rate among unvaccinated kids before the varicella vaccine was available. Shingles is not typically a childhood disease, so the rates would not be high among kids anyway, regardless of what the era is. But the rate among these vaccinated children was still almost 40 percent lower than among children in pre-varicella vaccine years. Read the rest of this entry »