harmful effects of second-hand smoke on children

If children live in a home where people do not smoke while the children are present, but do smoke a lot when they are not, how dangerous is the smoke that is in the carpet and furniture to their lungs?

Tobacco smoke that is released into the air by a cigarette, cigar, or pipe is known as second-hand smoke or Environmental Tobacco Smoke (ETS). It comes from the actual burning of the cigarette or the smoke that is exhaled (breathed out) by the smoker. This smoke contains several toxic parts that can lead to medical problems, including cancer.

Infants and children are most at risk from these toxins because their lungs are still developing and are considered more delicate. Children whose parents smoke have a higher chance of showing breathing problems. ETS has been associated with asthma, tonsillitis, bronchitis, pneumonia and other upper respiratory and lung infections. In addition, parents are very powerful role models for their kids. Children whose parents smoke are more likely to begin smoking themselves in adolescence.

How much harm does exposure to second-hand smoke cause? This depends on how much smoke is in the air and for how much time a person is exposed. The amount of ETS is affected by the size of the space, the number of people smoking in it and whether there is proper ventilation. After the smoking in an area has ended, it can take upwards of 3-4 hours to remove the smoke from just one cigarette and even then some of it may still linger.

There is a great amount of research to be done about the effects of second-hand smoke, including how harmful the leftover residue in places such as the carpet is. Currently the only known way to prevent these harmful effects of second-hand smoke is to never expose children. Not smoking at all is best for both the smokers and their children.
Henry H. Bernstein

murmur of MVP in children

Question : As a child I was dx with MVP. When I last saw my cardiologist for near fainting spells, unexplained racing beats while resting, and dizziness after swimming laps, I was told that I had grown out of it. I recently had a physical for my new job with the state and the physician asked me if I knew I had a heart murmur. I told him that as a child I had been dx with MVP and had an echo at 12. My question is why did the state physician hear a murmur (graded it at +2) and my cardiologist did not? I do not know if I have regurgitation, I am now 23. Should I have a repeat echo?

The murmur of MVP can be heard sometimes and inaudible at other times. Since your cardiologist didn't hear it, I doubt if you have a significant leak. If you are healthy and can exercise as well as others your age, I would never get another echo. MVP is benign, unlikely ever to have and bad effect on your heart. On the other hand, if you are worried, why not get another echo. Echoes are absolutely harmless.

levels of prolactin in blood

Question : I have high levels of prolactin in my blood. What does it mean?

Prolactin is a hormone from the pituitary gland that regulates the production of breast milk following childbirth. It also may suppress ovulation. The pituitary may produce too much prolactin as a result of use of certain drugs such as tranquilizers or oral contraceptives or — rarely — as a result of a pituitary tumor called a prolactinoma.

Prolactinomas occur in both women and men. In women, the prolactin may cause a milky discharge from the nipple, infertility or irregular or absent menstrual cycles. In men, it may lead to decreased interest in sex, impotence or infertility.

Elevated levels of prolactin in the blood (in the absence of medication known to cause it) warrants follow-up if the level remains elevated. Imaging of the pituitary with a CT or MRI scan may reveal a tumor. If a tumor is detected, treatment options include the medication bromocriptine or surgical removal of the tumor. The decision regarding the best option is based on specific findings. Usually, consultation with an endocrinologist is warranted.

Airplane travel with infants

Question: How old should a newborn/infant be before it is safe to take him on an airplane? What, if any, are the possible detrimental effects of taking an infant on board a plane?

There are both medical and safety aspects to your question.

Because newborn's bodies are rapidly adjusting after birth and because signs of illness in newborns may be subtle, neonatologists may advise against unnecessary air travel during the first 2 weeks of an infant's life.

The two most common related questions from parents are: "Does flying affect the child's ears?" and "Does flying increase the risk of sudden infant death syndrome (SIDS)?"

Flying affects infants' ears in the same way it affects adults' — changing cabin pressure causes changing middle ear pressure, which can distend the ear drum and result in pain and crying. Infants should nurse from the breast or take a bottle on the ascent and descent to equalize ear pressure. Infants with a recent ear infection might be more uncomfortable during the flight — check with your child's doctor before the trip if you have concerns. Your doctor can provide you with analgesic ear drops to use in case pain develops.

Little is known about the effects of changing altitude on young infants and whether the risk of SIDS is affected by air travel. At this time SIDS researchers believe that the risk of SIDS seems to be little altered by airplane travel.

According to the Federal Aviation Administration (FAA), "Flying is very safe, and mile for mile a child is safer flying unrestrained in an airplane than riding restrained in a motor vehicle."

insulin-dependent diabetes and birth defects

question: Can women with insulin-dependent diabetes reduce their risk of having children with birth defects?

Women who have insulin-dependent diabetes at the time they become pregnant have a two-to-three times greater risk of having malformed babies than other women. These malformations can affect the central nervous system, heart, kidneys and other organs. Unfortunately, the biochemical mechanisms or causes of such malformations are not yet known. But practically speaking, the risk of malformations can be reduced considerably with good metabolic control prior to the time the embryo's organs start developing. So if a woman with insulin-dependent diabetes has her blood sugar well-controlled before she gets pregnant, her risk of delivering a malformed baby as well as miscarriage is much, much lower.

source :An Interview with James L. Mills, M.D.,ificinfo.health.org

incidence of birth defects in USA

question: What is the incidence of birth defects today in the United States?

The risk for major malformations among the general population today is around two percent. Certain segments of the population, however, such as women with insulin-dependent diabetes and those who have given birth previously to a child with neural tube defects, have an increased risk of delivering malformed babies compared to the general population. In both of these latter instances, metabolic or nutritional factors are certainly important.
source :An Interview with James L. Mills, M.D.,ificinfo.health.org

Cat scratch fever in children

question My daughter has been diagnosed with cat scratch fever and no one really knows much about it. Can you tell me what you know about this infection? Should I get rid of the cat? Can my daughter get it again?

Cat scratch fever, also known as cat scratch disease, is an uncommon infection that occurs mostly in children. It follows a scratch or bite from a cat, usually a kitten, that shows no sign of illness. There is good evidence that the disease is caused by a bacterial agent or agents. In humans, there is usually evidence of infection at the site of injury and swelling of lymph nodes. Fever is present in less than half the cases.

Bacteria in an excised lymph node is strong evidence of the disease, as is a positive skin test to the organisms. However the skin test is not licensed and is not readily available.

Most people recover without treatment. The issue of lasting immunity is not clear but recurrences are rare. In instances where several persons have been scratched by an infected cat, less than 10 percent became ill. It should not be necessary to get rid of the cat.

mother breastfeeding - Does My Baby Need to Be on a Schedule?

Babies are as different from each other as are adults. Some babies, like some adults, naturally prefer a regular schedule with predictable times of feeding, sleeping, and activity. Other babies and adults seem to thrive on less regular schedules. As you get to know your baby and learn to recognize his/her cues, you will probably see some consistent patterns of sleeping and feeding, but they may vary from day to day. If well-meaning friends or relatives pressure you to "put that baby on a schedule," think about whether the schedule truly meets your baby's needs or if it's meant to please other adults. Learn to "watch your baby, not the clock," and know that responding to your baby is more important than trying to regulate him or her, mother breastfeeding.

Newborns need to eat very frequently, since the have tiny stomachs and since breastmilk is digested very rapidly. In the first few weeks, babies need to nurse ten to twelve times per day, and their feedings will gradually space out as they grow older. Any schedule that prevents newborns from breastfeeding at least every 2-3 hours (or less during growth spurts!) could potentially cause the baby to gain weight poorly, mother breastfeeding.

Healthy full term infants need to nurse every 2-3 hours during a 24 hour period. This equates to 8-12 feedings per 24 hours. A newborn should not go longer than 3 hours between feedings for two reasons 1) so that they get adequately nourished and hydrated and 2) to ensure that your breasts are stimulated enough to establish a full milk supply, mother breastfeeding.

mother breastfeeding - How can I tell if my baby is getting enough milk

Typically during the first few days, while the baby is only receiving colostrum, the newborn will wet only one or two diapers per day. Once mother's milk comes in, usually on the third or fourth day, the baby should begin to have 6-8 wet cloth diapers (5-6 wet disposable diapers) per day. Most young babies will have at least two to five bowel movements every 24 hours for the first several months. Remember output = input. Also, check to make sure that baby seems alert and content. Babies that sleep too much or are generally lethargic may need to be assessed by a pediatrician to make sure that he/she is not becoming dehydrated from a lack of time at the breast, mother breastfeeding.

If your baby has 6-8 cloth or 5-6 soaking wet disposable diapers, and 2-5 bowel movements in each 24 hour period, you can be sure that he/she is getting enough milk. Remember output = input. Also, check to make sure that baby seems alert and content. Babies that sleep too much or are generally lethargic may need to be assessed by a pediatrician to make sure that he/she is not becoming dehydrated from a lack of time at the breast, mother breastfeeding.

Any brand-new mom is going to be anxious about her baby getting enough to eat, and because breasts are neither see-through or marked off in ounces like a baby bottle, we have to look for other signs to make sure baby is getting enough milk.

Watch for these to tell if baby is getting enough milk - weight gain and wet and messy diapers.

From birth to four months, a breastfed baby will typically gain 4 to 8 ounces a week. From 4-6 months, baby will gain 3-5 ounces per week. From 6-12 months, weight gain slows to 1 1/2 - 3 ounces a week, mother breastfeeding.

Watch for 6-8 cloth or 5-6 wet disposable diapers and two or more bowel movements a day. An older baby, 2 months or more, may cut down on bowel movements and may even go several days between BMs. Rest assured that as long as baby is gaining weight and having wet diapers, baby is getting enough milk.

Some breastfed babies, after the newborn period has passed, have very infrequent bowel movements. This is no cause for alarm; it just means that the baby's system is so efficient at processing breast milk that no solid waste products are being produced. Breastfed babies cannot become constipated--when these babies do have a bowel movement, it will be loose, just like those of typical breastfed babies. It is still a good idea to mention very infrequent bowel movements to your health care professional, in case there is an underlying problem, mother breastfeeding.

learning kids...

Even though I have told my very intelligent 18-month-old daughter 100 times not to climb on the coffee table, she continues to do it, even though she understands when I say “NO!” I am very frustrated--is she being bad or am I expecting too much?

Children can understand "no" from a very early age...often by nine months. They figure it out by the tone of your voice and your facial expressions which essentially tell them, “I am not happy at all about what you are doing.” In general, childrens’ ability to understand what they hear (receptive communication) develops much sooner than their own ability to communicate by talking (expressive communication). However, while babies will often stop dead in their tracks when you tell them “NO!”, they do not yet have the capacity to exercise the self-control necessary to stop themselves from going for a desired object or engaging in an activity (such as climbing tables). Everything is so new and fun to explore! It is actually at your daughter’s age--around 18 months-- that toddlers begin to develop this capacity for self-control; but it is an ongoing process that develops over many months and varies with each child. By 2 ½ years most children can exert some self-control over their impulses. As you think about helping your child develop this capacity for self-control, it is important to be mindful of not just her age and stage of development, but also her temperament.

How does my child's temperament fit into her understanding of "NO!"?

While all children benefit from clear rules and consistent limit-setting so they know what to expect, and so they can make good decisions for how to behave, we need to adapt our strategies based on what we know about how our children typically approach the world. For example, feisty toddlers who are very persistent and intense emotionally may need more guidance and limits set by parents and caregivers. They also need consistency more than others. They are the kids who remember the one time you gave them that one extra cookie and will not let you forget it-pushing and pushing for that extra treat for months to come. On the other hand, laid back kids, who go with the flow, are more likely to accept changes in the rules; they don’t question that one day they get to watch one video, and the next they get two. Knowing what makes your child tick equips you with the best information for developing successful limit-setting strategies.