Philly Local: Hospitals Expand Safe Sleep Practices

Published on July 7, 2009 in THE PHILADELPHIA INQUIRER.

Hospitals push safe sleep practices for infants

By Heather J. Chin
Inquirer Staff Writer

For the last year, parents have been banned from sleeping with their sick babies at St. Christopher's Hospital for Children.

The hospital instituted the policy after three infants over three months were pronounced dead in the emergency room after bed sharing-related accidents at home.

Babies who sleep with a parent can become overheated, be rolled onto, or be smothered by soft sheets or pillows. They can also lose circulation if wedged between the mattress and furniture.

The hospital's ER typically gets one such death every couple of months. But the "little cluster" of tragedies early last year inspired St. Christopher's nurses to propose that the hospital lead by example.

"Today, people often don't have primary pediatricians," said emergency nursing director Kirsten Johnson-Moore. "So emergency departments, I feel, have a responsibility to educate and prevent."

Read the full story here...

HEALTH NEWS: Baby-Targeted TV Banned In France

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/28/2008

From the colorful costumes of "Barney and Friends" to Saturday morning cartoons like "Dora the Explorer," television programming has long targeted the pre-preschool set in America. If we take a cue from France, however, that could change.

Last week, the High Audiovisual Council, France's broadcast authority, banned French channels from airing any TV shows with a target audience of children under three years old. The goal, as stated in the published ruling, is to "protect children under three from the [negative] effects of television."

"Television viewing hurts the development of children under three years old and poses a certain number of risks, encouraging passivity, slow language acquisition, over-excitedness, troubles with sleep and concentration as well as dependence on screens," wrote the council.

The ruling affects both French channels and cable operators that air foreign channels, specifically BabyFirstTV and BabyTV. BabyTV is owned by Rupert Murdoch's News Corp. and BabyFirstTV is owned by a Fox Entertainment affiliate, as well as Netherlands-based and LA-based investment groups.

Program development will be affected and French cable operators that air foreign channels with baby-targeted programs will now be required to air warning messages to parents, such as: "Watching television can slow the development of children under three, even when it involves channels aimed specifically at them."

While such baby-marketed products are touted as specially designed for parent-baby interactive viewing, critics argue that such specific channels are more often used as a babysitting tool.

In a June newspaper interview, France's minister for culture and communication, Christine Albanel, also urged parents not to use 24-hour channels as a sleep aid, deeming it actually counterproductive to a good night's sleep. Research shows that background noise and artificial light such as those from TVs impede the body's ability to wind down and rest.

Area medical professionals agree. Dr. Gary Emmett, director of hospital pediatrics at Thomas Jefferson University Hospital, said, "While watching TV is not always harmful, it is not always helpful." It also often has long-term effects on learning and physical health, since the time spent in front of the TV takes away from other activities.

"Reading is directly correlated to success in school, while watching TV, and other things that [doctors] regard as passive, is not ... and is counter-related," he said.

Research published this July in the journal Childhood Development has also highlighted the negative effects of background noise on a toddler's ability to concentrate and learn, instead fostering restlessness and distraction.

BabyFirstTV first aired in the United States in 2006 to much debate over the value of such programming towards the youngest and most undeveloped, impressionable segments of society. The American Academy of Pediatrics recommends that children below age three should have zero hours of TV watching. However, a 2003 Kaiser Family Foundation study found that two-thirds of children under age six live in a home where the TV is on half the time, while one-third of children live in a home where it is on "most of the time" or "always."

According to Dr. Emmett, parents can help by fostering active playtime with other children and by reading storybooks with them. There is also a Philadelphia-area branch of the national charity NEMOURS that calls for a "two-one-five-zero" program: two hours or less of screen time a day, one hour of running or swift walking, five portions of fruit and vegetables a day and no sweets or sugary drinks.


Heather J. Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

HEALTH NEWS: Diabetes Before Pregnancy Linked To Birth Risk

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/13/2008

A study from the U.S. Centers for Disease Control and Prevention (CDC) reported that women with diabetes prior to becoming pregnant are eight times more likely to have children with multiple birth defects compared to women without diabetes.

The study found also that women with diabetes are three to four times more likely to give birth to a baby with at least one birth defect.

Women with pregnancy-induced diabetes, or gestational diabetes, were also found more likely to have a child with a birth defect, although usually only if they were overweight or obese at conception. This range would mean a body mass index (BMI) - weight measured in proportion to height - of 25 or higher.

The study expanded on previous research by examining women with type 1 and type 2 diabetes as well as gestational diabetes, and considering both cardiac and non-cardiac defects, nearly 40 in all.

Only 2 percent of babies with single birth defects and 5 percent with multiple defects were born to mothers with pre-pregnancy diabetes, while 93 percent of the birth defects examined were not associated with maternal diabetes.

Overall, diabetes diagnosed before pregnancy was linked with about half of the birth defect categories examined.

Birth defects may include heart problems, brain and spinal defects, oral clefts, limb deficiencies, and kidney and gastrointestinal tract defects. These affect 1-in-33 infants and are a leading cause of infant death, according to the CDC. Most causes are unknown.

The findings were based on data analyzed from over 13,000 infants with birth defects and nearly 5,000 without defects, all born between 1997 and 2003. Of those without defects, 24 mothers had diabetes before diabetes. Of those newborns with defects, 283 mothers had pre-pregnancy diabetes.

All children were part of the National Birth Defects Prevention Study, which drew data from 10 birth-defect surveillance systems in 10 states.

However, according to Janis Biermann, a spokeswoman for the March of Dimes which reviewed the study for WebMD, women shouldnotbe unduly concerned.

"Just because there is an increased risk of a baby having a birth defect if a woman has preconception diabetes doesn't mean it is going to happen," she said, "It just means there is a greater chance than if a woman doesn't have it."

The study is the largest yet done to identify the range of birth defects linked to pre-pregnancy diagnoses of diabetes, but the link itself has been known for almost two decades. Researchers hope that increased awareness will encourage people to seek the best available everyday preconception care.

"Early and effective management of diabetes for pregnant women is critical in helping to not only prevent birth defects, but also to reduce the risk for other health complications for them and their children," said lead author Dr. Adolfo Correa, an epidemiologist at the CDC's National Center on Birth Defects and Developmental Disabilities, in a news release.

According to the March of Dimes, about 1.85 million U.S. women of childbearing age have diabetes.

"The most important thing is that the patient ... get [her diabetes] in control," said Dr. Louis Weinstein, M.D., professor and chairman of OBGYN at Thomas Jefferson University.

In an urban area such as Philadelphia, "we tend to see more diabetes than in other parts of the country because we have lower socioeconomic populations with higher BMI [levels] than elsewhere," Dr. Weinstein added.

"It's important to take care of yourself, exercise, be at an optimal weight, plan your pregnancy, and make sure the diabetes is well controlled before you get pregnant," Ms. Biermann, from the March of Dimes, said to WebMD.

Once pregnant, Ms. Biermann notes the importance of following the same healthy habits and having regular prenatal care, along with regular appointments with a diabetes specialist for those diagnosed.

The report was published this month in the American Journal of Obstetrics & Gynecology.

Heather J. Chin can be reached at hchin@thebulletin.us.

©The Evening Bulletin 2008