Study reveals link between neonatal and early childhood outcomes among premature infants-Close surveillance is needed

Whoa... one in five babies who appeared healthy at the time of hospital discharge had cerebral palsy or neurologic impairment at 2 years of age"!! 

Close follow-up with a specialist interested in maximizing your baby's potential for learning growth and development.

Dr. Rotenberg,
Member American Academy of Cerebral Palsy & Developmental Medicine

In a study to be presented on Feb. 6 at 3:15 p.m. CST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting-, in New Orleans, researchers will report on a correlation between initial neonatal and early childhood outcomes among children delivered less than 34 weeks gestation.

Preterm babies are at high risk for death and other serious medical complications, and some premature infants continue to experience side effects from prematurity even during later childhood. It's uncertain whether preterm babies diagnosed with intestinal problems, severe
respiratory problems, bleeding in their brains, and other complications during their stay in the newborn intensive care unit (NICU) after birth will continue to have complications when examined later in childhood.

This study examined more than 1,700 babies who were born prematurely at less than 34 weeks gestation. It then followed babies after they were discharged from the NICU and re-evaluated them as 2-year-olds for evidence of cerebral palsy and neurologic impairment.

Results revealed that about one in five babies who appeared healthy at the time of hospital discharge had cerebral palsy or neurologic impairment at 2 years of age. Further, one in three babies who had one or more serious complications during their NICU stay also had these complications.

"Babies delivered preterm are at high risk for complications as newborns and also later in childhood," said Tracy Manuck, M.D., one of the researchers and co-director of the University of Utah Prematurity Prevention Clinic. "We found that babies who had serious complications in the newborn intensive care unit were more likely to have cerebral palsy or neurologic impairment in early childhood, but not necessarily. The converse is also true, as about one in five babies who appeared healthy at the time of hospital discharge had complications in early childhood. Early childhood evaluation and interventions should not be withheld from seemingly healthy previous preterm children."

However, Manuck noted that the relationship between serious NICU complications and serious neurologic impairment in early childhood was not perfect, as the NICU complications were only moderately predictive of prognosis later in childhood.

Read article here.

Winter is worse time for people with asthma

Asthma symptoms may remain dormant for some time before surfacing during a high risk time period.  Winter and "virus season" often uncovers asthma that may not be adequately controlled. Dr. Susarla

Winter is worse time for people with asthma 

(CNN) — Asthma affects more than 22 million Americans of all ages.

It can be challenging, even dangerous, for asthmatics who don't take proper care of themselves.

And the wintertime poses its own set of triggers.

Gayle Richardson is breathing easier these days, now that she has her asthma under control.

But certain things trigger her condition, especially this time of year.

“I have more issues with asthma in the wintertime because of the colds and the flu virus that are floating around, if I get something like that, it will definitely have a stronger effect on me,” Richardson explained.

This is common in people with the chronic lung condition, says Dr. Stanley Fineman:

“Because the asthmatic has airways that are very hyper-sensitive, they're already inflamed, so the virus does more damage in the asthmatic patients than they would do in somebody who doesn't have asthma.”

Inflamed and swollen lungs can make it difficult to breathe.

To minimize attacks during winter, Dr. Fineman offers advice to patients.

Most importantly, know your triggers.

Cold air can exacerbate the condition, as can windy weather.

But also, stay on long-term control medication.

Remember indoor irritants too, things like: smoke, scented candles and fireplaces.

He recommends a flu shot for everyone with the condition.

And his final tip to keep healthy could be the simplest.

Good hand washing and good hygiene is also important.

Read article here.

Some Asthma Patients May Be Overmedicated, Doctors Say

How is your child's asthma managed?  National asthma guidelines stress the importance of  scheduled reassessment of asthma control, which under the proper direction can reduce excessive use of asthma medication.  Consult a pediatric pulmonologist for asthma check-ups for best guidance coupled with state of the art lung function testing to help achieve the right balance.  Dr. Susarla 

Some Asthma Patients May Be Overmedicated, Doctors Say

People with mild asthma are advised to lower their medication dose once their asthma has been brought under control, but the best way to reduce the dose is not fully known, doctors say.

As a result, patients may be staying on higher doses than what's necessary to keep their condition under control.

"We need to find a way to help patients control their asthma, without overmedicating them," said Dr. John Mastronarde, director of the Asthma Center at Ohio State University's Wexner Medical Center.

"Right now, the recommendation is to reduce a patient's therapy once the asthma is controlled for at least three months," Mastronarde said.
To control asthma, patients typically take drugs called inhaled corticosteroids, to reduce inflammation in the lungs, and long-acting beta agonists (LABAs), to open the airways. Doctors adjust the medication dose based on the patient's symptoms and lung function.
Once a patient's asthma is controlled, the drug dose should be lowered carefully, to the minimum dose necessary, according to the National Institutes of Health's guidelines for treating asthma.
"But that's where things just don't happen," Mastronarde said. "Once you get the symptoms under control, sometimes both the patient and the doctor just leave the patient on whatever they are on, because they don't want it to get worse again."
Although low doses of inhaled corticosteroids are safe, it is thought that taking high doses of the drugs for a long time may weaken the bones, especially in post-menopausal women, or possibly increase the risk of eye cataracts. Higher doses also cost more, Mastronarde noted.
Long-acting beta agonists may have some effects on a person'sheartbeat and blood pressure. The U.S. Food and Drug Administration recommends these drugs be used for the shortest time needed to control asthma symptoms, and that they be discontinued if possible.
Although lowering the doses of these medications is recommended, no one knows the best way to do that, Mastronarde said.
To help establish guidelines, Mastronarde and his colleagues are launching a yearlong study to examine 450 people with moderate asthma, who will receive inhaled corticosteroids and beta agonists for eight weeks. For the participants whose asthma is well controlled, the researchers will then see which method would work better: reducing the doses of their medication, or eliminating the beta agonists.
But in the meantime, patients whose asthma is controlled for three months can talk to their doctor about whether they can decrease their medication dose, Mastronarde said.

Read article here.

Attention Parents of Premature and Vulnerable Infants: Houston NICU Follow Up Clinic

Attention Parents of Premature and Vulnerable Infants: Houston NICU Follow Up Clinic

New Service Announcement:

I am writing to introduce our community to  our  cross-disciplinary NICU follow-up clinic. 

Our goals are: 

1) to augment /bridge services for infants at risk, and 

2) to increase meaningful engagement with rehab and support services when needed. 

Dr Susarla will lead this effort from a pulmonary/feeding perspective and 

Dr Rotenberg will monitor any neurology / neurodevelopmental issues. 

Follow This Link to Our Referral Form

Who is a candidate?
☐ Prematurity
☐Low Birth Weright (<1500g a="" nbsp="">
☐Apnea 
☐Chronic lung disease 
☐Dysphagia 
☐Tachypnea 
☐Tracheomalacia
☐Craniofacial  disorders
☐Tracheostomy/Home ventilator
☐Developmental Delay 
☐Hypotonia 
☐Seizures 
☐Intraventricular hemorrhage 
☐Congenital infection 
☐Neonatal stroke
☐ Genetic Abnormality
☐Congenital Anomalies 
☐Abnormal hearing screen
☐GE Reflux/aspiration
☐Abnormal Metabolic Screen
☐Laryngomalacia
☐Vocal cord paralysis


For scheduling questions, please call:
Phone 713-464-4107
Fax 713-464-4522
www.txmss.com

Study: Preemies are at a higher risk of asthma

A study shows that babies born prematurely are more likely to develop asthma, although the reason why this is so is not completely understood.

The World Health Organization estimates that 15 million babies are born premature every year, which means they are born before 37 weeks. But new research suggests that risks are higher than previously thought for preterm babies to develop childhood asthma, compared with their full-term counterparts.

Publishing their results in the journal PLoS Medicine, the researchers studied data on more than 1.5 million children around the world.

They used information on patients born since the 1990s from 30 studies, which came from six continents. The majority of the studies came from Europe.

Preterm babies often encounter breathing problems because their lungs are immature, the authors note. They drew from previous research on preterm children born between the 1960s and 1980s, which showed that many of them developed asthma.

However, the researchers say it was unclear whether improved care for preterm babies since then has affected the long-term risk of developing asthma.

Asthma is the most common chronic disease in children, and the team notes that because an increasing number of preterm babies survive birth, the condition is becoming a "significant health problem."

Preterm babies 50% more likely to develop asthma

Overall, the study revealed that while asthma affects 8% of children born at full term, it affects 14% of preterm babies.

In detail, the team found that babies born before 37 weeks were 50% more likely to develop asthma, and those born 2 months early were three times as likely to develop asthma, compared with full-term babies.

Additionally, risks of developing the breathing condition were the same for preschoolers and school-age children, which suggests children who are born early do not outgrow the risk.

"Doctors and parents need to be aware of the increased risks of asthma in premature babies, in order to make early diagnosis and intervention possible," says Dr. Jasper Been, lead study author from the University of Edinburgh's Centre for Population Health Sciences in Scotland.

Dr. Been adds:

"By changing the way we monitor and treat children born preterm, we hope to decrease the future risks of serious breathing problems, including asthma. Our findings should help find better ways to prevent and treat asthma and asthma-like symptoms in those born preterm."

Standard asthma meds 'safe in pregnancy'

The authors say the results of their study provide "compelling evidence" that preterm birth increases asthma risks, and they note that future research "needs to focus on understanding underlying mechanisms, and then to translate these insights into the development of preventive interventions."

But Dr. Samantha Walker, executive director of research and policy at Asthma UK, emphasizes the importance of current asthma medications:

"Standard asthma medicine is very safe to use in pregnancy, and by far the most important way to reduce this risk is for pregnant women to take their medication as prescribed."

She adds that maintaining a healthy weight, staying active, avoiding stress and not smoking are also important measures to keep in mind.

When asked about any further research the team has planned, Dr. Been told Medical News Today:

"An important factor that causes both preterm birth and asthma, particularly in those born preterm, is tobacco smoke exposure before birth. Our current research focuses on evaluating interventions to address this issue."

In other asthma news, a study recently suggested that secondhand smoke is linked to hospital readmission for asthmatic children. The authors of that study believe their findings could prompt insurance companies to give incentives to parents or guardians who quit smoking.

Read more here

Dr. Rotenberg of Houston and Sugar Land - Named to the National List of Comprehensive List of GOOD Child Neurologists…Epileptologists…Neurosurgeons…and Pediatric Doctors

2014 Comprehensive List of GOOD Neurologists…Epileptologists…Neurosurgeons…and Pediatric Doctors | January 5, 2014

2 Votes

Below is a compilation by website forum members who have had positive experiences with docs over the years.

This list is based on personal recommendations and, of course, is purely subjective.

But I thought it might be helpful for anyone looking for a good Neurologist…Epileptologist…Neurosurgeon…or Pediatric Doctor.

NOTE: The National Association of Epilepsy Centers (NAEC) provides a directory of specialized epilepsy centers in the U.S. along with other useful information about epilepsy.http://www.naeclocator.org/find.htm

Link to list here

Thank you for the recognition and confidence.

Serving Houston, Sugar Land, Missouri City, Rosenberg, Katy, Cinco Ranch, Cypress, the Woodlands

Obese children more susceptible to asthma

A study claims that obese children are more susceptible to asthma that is caused by air pollution.

Obese children exposed to high levels of air pollutants were nearly three times as likely to have asthma, compared with non-obese children and lower levels of pollution exposure, report researchers at Columbia University Medical Center (CUMC), including Columbia's Mailman School of Public Health.

Rates of childhood obesity and asthma have both increased dramatically in the past 30 years. The percentage of American children who are obese has increased from 7% in 1980 to 20% in 2008. Childhood asthma is up from 4% in 1980 to 10% in 2009. Rates are higher among urban minority populations.

The researchers followed 311 children in predominantly Dominican and African-American neighborhoods of New York City. They monitored indoor air in each child’s home for two weeks at age 5 or 6, to measure exposure to a family of air pollutants, polycyclic aromatic hydrocarbons (PAH). The child’s height and weight were measured and respiratory questionnaires were administered. In all, 20% were found to have asthma and 20% were categorized as obese based on body mass index.

The researchers found that high PAH exposure was associated with asthma only among obese children. In particular, the association was with the alkylated forms of PAH, which are emitted by vehicles and by cigarette smoke, cooking, incense, burning candles, and various other indoor sources. A two- to three-fold increase in asthma risk was seen among obese children exposed to high levels of the PAH chemicals 1-methylphenanthrene and 9-methylphenanthrene. Exposure to PAH or obesity alone did not predict asthma.

“Our results suggest that obesity may magnify the effects of these air pollutants, putting children at greater risk for having asthma,” says lead author Kyung Hwa Jung, PhD, associate research scientist in the Department of Medicine at Columbia University College of Physicians and Surgeons (P&S).

The mechanism behind the association is not well understood. One possible explanation is that sedentary lifestyle in obese children could result in more time spent indoors, thereby increasing exposure to indoor PAH. Another may have to do with more rapid breathing in those who are obese.

Better understanding of the risk factors opens the door to more targeted interventions. “These findings suggest that we may be able to bring down childhood asthma rates by curbing indoor, as well as outdoor, air pollution and by implementing age-appropriate diet and exercise programs,” says senior author Rachel Miller, MD, Professor of Medicine (in Pediatrics) and Environmental Health Sciences, chief of Pediatric Allergy and Immunology at CUMC, and co-deputy director of the Columbia Center for Children’s Environmental Health at the Mailman School of Public Health.

The study builds on earlier research findings that linked increased asthma risk with exposure to higher levels of air pollution. Drs. Jung and Miller previously had shown an association between repeated high prenatal and childhood PAH exposure and asthma. A number of studies also have found an association between obesity and asthma.

Support for the study was provided by the National Institute of Health grants R01ES013163, P50ES015905, P01ES09600, R01ES08977, and P30ES09089; Environmental Protection Agency grants R827027, RD832141, and RD834509; the Educational Foundation of America; the John and Wendy Neu Family Foundation; the New York Community Trust; and the Trustees of the Blanchette Hooker Rockefeller Fund.

Matthew Perzanowski, Andrew Rundle, Kathleen Moors, Beizhan Yan, Steven N. Chillrud, Robin Whyatt, David Camann, and Frederica P. Perera also contributed to the study. None of the authors has financial relationships with a commercial entity that has an interest in the subject of this manuscript.

Full results are published in the journal Environmental Research.

Read more here

When to be concerned about a child's cough or cold

This article details when parents should become concerned about a child's cough and cold.

Your baby’s cold is lasting 10 days. Your toddler’s earache persists all weekend. Your teenager’s cough lingers for weeks. When should you worry? That is to say, when should you really worry, going a step beyond generalized parental anxiety to actual, galvanizing concern? How long is too long?

A paper recently out in the BMJ offers some welcome answers to that eternal question, and we’ve converted them into the simple bar chart. The lead author of the paper, Dr. Matthew Thompson, professor of family medicine at the University of Washington and researcher at Oxford, says he’d be happy to see it posted on many a fridge.

With one important proviso, however: Just because the duration of a child’s illness is within the expected range, that’s no reason to ignore other causes for concern. “If you’re still worried, if your child is getting sicker and sicker, and there’s something else going wrong — they’re not feeding well, having difficulty breathing, extremely high fever — you do need to take those things seriously,” Dr. Thompson said. “As parents, as doctors, we’re not just interested in duration of illness, we’re also interested in how severe the symptoms are.”

The biggest message is that people worry too soon.

Point taken. But now let’s talk about the millions of other cases in which parents bring their winter-virus-ridden children in to see the doctor purely because it seems like the sickness is dragging on for longer than it should. Having all these duration numbers in one place could help save some of that time, effort, and most of all, anxiety, Dr. Thompson says.

“When parents come in with their child to see a pediatrician or a family doctor, they’ve got two questions when their child has a cough or a cold or that kind of illness,” he said. “Number one is, how long is it going to last, doctor? And the second is, is there anything that is going to make it better? We really wanted to get more accurate information for that first question: how long will it last?”

Dr. Ben Kruskal, chief of infectious disease at Harvard Vanguard Medical Associates, notes that lowering parental anxiety could also help cut down the overuse of antibiotics, an important goal in this time of rising germ resistance.

“The biggest message is that people worry too soon,” he said, “and when people come into the office, they’re more likely to get treated with antibiotics that are almost invariably unnecessary in this setting. It’s not that there aren’t some genuine reasons to use antibiotics, but if you get 100 unnecessary visits, a few of them are going to generate unnecessary antibiotics. If you get 200 unnecessary visits, you’re going to get twice as many unnecessary antibiotics.”

The persistent cough is the source of the greatest gap between viral reality and parental expectations, both Dr. Kruskal and Dr. Thompson said.

“We found that cough lasts for 25 days in 90 percent of children, which is much, much longer than most parents would estimate,” Dr. Thompson said. “So it’s very, very common for us to see children being brought in for a cough that’s gone on for a week, or two weeks, but it’s not actually unexpected to see coughing symptoms going on for three weeks. It doesn’t mean the child’s got pneumonia, it doesn’t mean they’ve got asthma, it doesn’t mean there’s anything particularly wrong. It just takes a while for cough symptoms to get better.”

The paper’s finding on earache duration for nine out of 10 children — up to eight days — is also particularly worth highlighting, he said, because it is longer than previous CDC estimates and most parents’ expectations.

Do we really need this antibiotic or could we wait a few days?

Earaches generate a great deal of antibiotic use in children, and “clearly, there are some situations where ear infections do need an antibiotic,” Dr. Kruskal said. But “the take-home for parents might be, number one, don’t push for an antibiotic, and in fact, if a pediatrician is writing a prescription, ask, ‘Do we really need this or could we wait a few days?’”

The CDC and other health authorities offer “average duration” for many illnesses, but they can be confusing. From the BMJ paper:

For example, the 2008 National Institute for Health and Care Excellence guidelines for treatment of respiratory tract infections include estimates of average duration of the illness (before and after seeing a doctor) of four days for acute otitis media, one week for acute sore throat, one and a half weeks for the common cold, and three weeks for acute cough or bronchitis.8 By contrast, information for patients from the US Centers for Disease Control and Prevention describe sore throat as lasting one to two weeks, common cold lasting up to two weeks, and cough duration ranging from two to eight weeks.9 The durations quoted in these sources reflect findings based on expert opinion or from individual studies rather than from data synthesis of multiple studies and are not child specific.

The BMJ paper undertook a full-fledged, systematic review of existing scientific literature to determine how long respiratory-tract ailments last when untreated or treated only with symptom-relievers — over-the-counter medicines which temporarily make kids feel better but don’t affect the course of the illness.

The United-Kingdom-based research team combed through more than 10,000 papers and found about 50 papers that gave them information on about 2,500 children, Dr. Thompson said.

“This is the first time that we’ve been able to bring together all the studies which have looked at different kinds of respiratory infections in children,” he said, “so that we can present, all in one place, the expected length of illness for cough, cold, sore throat, ear infection and croup.”

The numbers should be disseminated widely among both clinical staff and the general public, said Dr. Kruskal, who was not involved with the paper.

But what about the frightening possibility that they might keep some parents from calling the doctor when they should?

“People are worried enough,” he said, “that even if we down-modulate things a bit, they’re still going to be more worried than they need to be.”

Read more here

No technology helps kids get healthy sleep

This article explains why having no technology in a child's bedroom is pivotal to ensure the child gets healthy and quality sleep.

Here's the scenario: A child is glued to his Xbox, or maybe his iPhone or iPad and won't go to bed. Frustrated, mom or dad gives up the fight and walks away, letting the kid play just a little longer -- even though it's a school night.

But an expert on children's sleep says parents need to buck-up.

Dr. Daniel Lewin, associate director of Pediatric Sleep Medicine at Children's Medical Center, says he too has a child who wants to be on the computer constantly.

"It's simply modeling and limit setting, which is critical," Lewin says.

It comes down to parents limiting their own exposure to electronics, especially while in front of children. This helps show the behavior they'd like their kids to mimic.

Lewin says in a culture with constant access to electronic media, there's a lot of pressure to perform.

But "those kids who are on media devices to do their homework and when that's done right before bedtime they're impacting their sleep," says Lewin.

When it comes to kids, Lewin recommends making sure the electronics are off at least an hour before bedtime. That's because the light actually shuts down the biological process that initiates sleep.

"Sleeping with a dim light in the bedroom is fine. But sleeping with electronics on in the bedroom is really not optimal," Lewin says.

For children who take ADHD medication, Lewin says it's extra important to make sure he or she is getting a good night's sleep.

"Getting enough sleep at night is critical for attention, for regulation of emotion," says Lewin. He says it's really important to be able to recognize the signs of sleep disorder and to recognize the signs of inadequate sleep.

"We have a lot of kids who are on ADHD medications. We could start by optimizing sleep before putting kids on medications. Some certainly need it," Lewin says.

There's also a relationship between sleep deprivation and mood, including suicidal thoughts. Chronic sleep deprivation can lead to high blood pressure, strokes and Type 2 diabetes.

Children around the ages of 12 and 13 should get 9.5 to 10 hours of sleep. Older children and adolescents should get about 9.5 hours of sleep.

And, Lewin adds, "The American Academy of Pediatrics has been very clear: no TVs in the bedroom and no electronics in the bedroom absolutely critical."

Read more here

Heart defects in children linked to environmental toxin exposure during pregnancy

A study shows that environmental toxin exposure during pregnancy is linked with heart defects in children.

Congenital heart defects in children may be associated with a mother's exposure to specific mixtures of environmental toxins during pregnancy, according to research recently presented at the Scientific Sessions conference sponsored by the American Heart Association.

Congenital heart defects occur when the heart or blood vessels near the heart fail to develop normally before birth. Defects may be caused by chromosomal abnormalities, but the cause is unknown in most cases, according to the research.

Researchers examined patterns of congenital heart defects incidence and presence of environmental toxins in Alberta, Canada. The ongoing research seeks to determine if pregnant women’s proximity to organic compounds and metals emitted in the air impacts the risk of heart defects in their children.

“Although still in the early stage, this research suggests some chemical emissions -- particularly, industrial air emissions -- may be linked to heart abnormalities that develop while the heart is forming in the womb,” said lead researcher Dr. Deliwe P. Ngwezi, a student and research fellow in pediatric cardiology at the University of Alberta in Canada.

The study is based on congenital heart defects diagnosed in 2004 through 2011 and chemical emissions recorded by a Canadian agency tracking pollutants.

Researchers looked at three chemical categories, but only one group showed a strong correlation with rates of congenital heart defects.

Ngwezi said the group of chemicals consists of a mixture of organic compounds and metals namely: benzene, butadiene, carbon disulphide, chloroform, ethylene oxide, hexachlorobenzene, tetrachloroethane, methanol, sulphur dioxide, toluene, lead, mercury and cadmium.

Congenital heart defect rates have gradually decreased in Canada since 2006, which is about the time the government tightened regulations to reduce industrial air emissions, Ngwezi said.

The heart defect decreases were mainly associated with heart defects resulting in holes between the upper and lower heart chambers and malformations of the cardiac outflow tracts Ngwezi said.

“For now, consumers and health care providers should be educated about the potential toll of pollutants on the developing heart,” she said. “As we have observed in the preliminary results, when the emissions decrease, the rates of congenital heart defects also decrease.”

This study, she said, should draw attention to the increasing evidence about the impact of environmental pollution on birth defects.

Limitations of the study include that observations were made at a group level, not according to individual risk and the self-reported industry data that is monitored and collected annually by the government, Ngwezi said.

Read more here

Whooping cough in children is spreading over California and Nevada

Recently, outbreaks of whooping cough in children have been seen recently in California and Nevada.

California has seen a sharp increase in cases of whooping cough, a highly contagious respiratory disease once thought to be nearly eradicated.

State data shows the number of reported cases of whooping cough, also known as pertussis, rose from 1,023 in 2012 to 1,669 last year. About 83 percent of the cases were in children ages 7 to 16, theSacramento Bee reported recently. Ninety-nine patients went to the hospital, but no deaths were reported.

California health officials say one reason for the increase is declining immunity among children who were vaccinated years earlier but haven’t gotten the booster shot recommended at ages 11 or 12. Other factors include the disease’s cyclical nature and more parents opting out of immunizations for their children.

Nevada County saw the sharpest increase in cases per 100,000 residents, from five in 2012 to 70 cases last year. Marin County ranked second, with 173 cases in 2013.

“Evidence shows that pertussis outbreaks are more likely in communities with clusters of unvaccinated people,” said Dr. Ken Cutler, Nevada County’s health officer. “It is also clear that people who are unvaccinated are more likely than those who are vaccinated to get pertussis and to have more severe symptoms.”

Caused by a bacterium, whooping cough causes violent coughing that makes it hard to catch one’s breath. Coughing spells can last for 10 weeks. It typically affects babies and young children and can be fatal for infants younger than 1 year old.

“Babies who are really young do not have the protection they need against the disease,” said Olivia Kasirye, Sacramento County’s public health officer. “They depend on the community for the protection.”

The Centers for Disease Control and Prevention last year received reports of 48,000 cases of pertussis nationwide last year, more than in any other year after immunizations became widely available.

California is one of 20 states that allow parents to exempt their children from public school immunization requirements if they have personal objections.

Read more here

Asthma may be caused by common colds during pregnancy

A study found an association between pregnant women who had the common cold and their children developing asthma.

Women that are pregnant may want to take extra precaution around those that are sniffling and sneezing this winter. According to a new study published today, the more common colds and viral infections a woman has during pregnancy, the higher the risk her baby will have asthma.

The study, published in the February issue ofAnnals of Allergy, Asthma and Immunology, found a mother's infections and bacterial exposure during pregnancy affect the in utero environment, thus increasing a baby's risk of developing allergy and asthma in childhood.

"In addition, these same children that had early exposure to allergens, such as house dust and pet dander, had increased odds of becoming sensitized by age five," said allergist Mitch Grayson, MD, Annals deputy editor and fellow of the American College of Allergy, Asthma and Immunology (ACAAI). "When dust mites from the mother and child's mattresses were examined, children with high dust mite exposure yet low bacteria exposure were more likely to be allergic to dust mites than those with low mite exposure and high bacteria contact."

Researchers studied 513 pregnant women in Germany, and their 526 children. Questionnaires were completed during pregnancy, when the children were three and 12 months old, and every year up to five-years-old. Of the families, 61 percent had a parent with asthma, hay fever or atopic dermatitis.

According to the ACAAI, asthma and allergy can be hereditary. If both of a child's parents have allergies, the child has a 75 percent chance of being allergic. If one of the parents is allergic, or if a close relative has allergies, the child has a 30 to 40 percent chance of having some form of allergy. If neither parent has allergy, the chance is only 10 to 15 percent.

"We know that allergy and asthma can develop in the womb since genetics play a factor in both diseases," said allergist Michael Foggs, MD, ACAAI president. "But this study sheds light about how a mother's environment during pregnancy can begin affecting the child before birth."

Asthma is the most common potentially serious medical condition to complicate pregnancy, according to the ACAAI. In fact, asthma affects approximately 8 percent of women in their childbearing years. When women with asthma become pregnant, one-third of the patients improve, one-third worsen and one-third remain unchanged.

Women who are or plan on becoming pregnant should continue speaking with their board-certified allergist about treatment options and how to eliminate symptom triggers. More information and a video about allergy and asthma during pregnancy, visit http://www.acaai.org/pregnancy.

Read more here

Study: Later school start times are beneficial for adolescents

A study shows that later school start times result in improved sleep quality and a better overall mood in adolescents.

Julie Boergers, Ph.D., a psychologist and sleep expert from the Bradley Hasbro Children's Research Center, recently led a study linking later school start times to improved sleep and mood in teens. The article, titled "Later School Start Time is Associated with Improved Sleep and Daytime Functioning in Adolescents," appears in the current issue of the Journal of Developmental & Behavioral Pediatrics.

"Sleep deprivation is epidemic among adolescents, with potentially serious impacts on mental and physical health, safety and learning. Early high school start times contribute to this problem," said Boergers. "Most teenagers undergo a biological shift to a later sleep-wake cycle, which can make early school start times particularly challenging. In this study, we looked at whether a relatively modest, temporary delay in school start time would change students' sleep patterns, sleepiness, mood and caffeine use."

Boergers' team administered the School Sleep Habits Survey to boarding students attending an independent high school both before and after their school start time was experimentally delayed from 8 to 8:25 a.m. during the winter term.

The delay in school start time was associated with a significant (29 minute) increase in sleep duration on school nights, with the percentage of students receiving eight or more hours of sleep on a school night jumping from 18 to 44 percent. The research found that younger students and those sleeping less at the start of the study were most likely to benefit from the schedule change. And once the earlier start time was reinstituted during the spring term, teens reverted back to their original sleep levels.

Daytime sleepiness, depressed mood and caffeine use were all significantly reduced after the delay in school start time. The later school start time had no effect on the number of hours students spent doing homework, playing sports or engaging in extracurricular activities.

Boergers, who is also co-director of the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital, said that these findings have important implications for public policy. "The results of this study add to a growing body of research demonstrating important health benefits of later school start times for adolescents," she said. "If we more closely align school schedules with adolescents' circadian rhythms and sleepneeds, we will have students who are more alert, happier, better prepared to learn, and aren't dependent on caffeine and energy drinks just to stay awake in class."

Read more here