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Tag: infants

  • How to Beat Heart Disease Before It Starts | NutritionFacts.org

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    Why might healthy lifestyle choices wipe out 90% of our risk for having a heart attack, while drugs may only reduce risk by 20% to 30%?

    On the standard American diet, atherosclerosis—hardening of the arteries, the number one killer of men and women—has been found to start in our teens. Investigators collected about 3,000 sets of coronary arteries and aortas (the aorta is the main artery in the body) from victims of accidents, homicides, and suicides who were 15 to 34 years old and found that the fatty streaks in arteries can begin forming in our teens, which turn into atherosclerotic plaques in our 20s that get worse in our 30s and can then become deadly. In the heart, atherosclerosis can cause a heart attack. In the brain, it can cause a stroke. See the progression below and at 0:35 in my video Can Cholesterol Get Too Low?.

    How common is this? All of the teens they looked at—100% of them—already had fatty streaks building up inside their arteries. By their early 30s, most already had those streaks blossoming into atherosclerotic plaques that bulged into their arteries. From ages 15 through 19, their aortas had fatty streaks building up throughout them, but no plaques yet, on average, as seen below and at 1:15 in my video.

    The plaques started appearing in their abdominal aorta in their early 20s and worsened by their late 20s, by which time fatty streaks had infiltrated throughout. By their early 30s, their arteries were in bad shape, as seen below and at 1:25 in my video.

    But that’s just the abdominal aorta, the main artery running through the torso that splits off into our legs. What about the coronary arteries that feed the heart?

    Researchers found the same pattern: fatty streaks in teens, early signs of plaque in early 20s that progress with age, and by the early 30s, most people already had plaques in their coronary arteries, as seen below and at 1:47 in my video.

    Atherosclerosis starts as early as adolescence.

    That’s why we shouldn’t wait until heart disease becomes symptomatic to treat it. If it starts in our youth, we should start treating it when we’re youths. If you knew you had a cancerous tumor, you wouldn’t want to wait until it grew to a certain size to treat it. If you had diabetes, you wouldn’t want to wait until you started going blind before you did something about it. So, how do you treat atherosclerosis? You lower LDL cholesterol through a diet low in saturated fat and cholesterol—a diet that’s low in eggs, meat, dairy, and junk.

    If we want to stop this epidemic, we have to “alter our lifestyle accordingly, beginning in infancy or early childhood. Is such a radical proposal totally impractical?” (Eating more healthfully? Radical?!) It would take serious dedication to change our behavior, but atherosclerosis is our number one cause of death. In the case of cigarettes, we did pretty well, slashing smoking rates and dropping lung cancer rates. And, yes, healthy eating is safe. According to the Academy of Nutrition and Dietetics, the largest and oldest association of nutrition professionals in the world, even strictly plant-based diets are appropriate for all stages of life, starting from pregnancy. (NutritionFacts.org is among the websites recommended by the Academy for more information.)

    The title of an important study published in the Journal of the American College of Cardiology declares: “Curing Atherosclerosis Should Be the Next Major Cardiovascular Prevention Goal.” What evidence do we have that a lifelong suppression of LDL will do it? There is a genetic mutation of a gene called PCSK9 that about 1 in 50 African Americans are lucky to be born with because it gives them about a 40% lower LDL cholesterol level their whole lives. Indeed, they were found to have dramatically lower rates of coronary heart disease—an 88% drop in risk compared to those without the genetic mutation, despite otherwise terrible cardiovascular risk factors on average. Most had high blood pressure and were overweight, almost a third smoked, and nearly 20% had diabetes, but that highlights how a lifelong history of low LDL cholesterol levels can substantially reduce the risk of coronary heart disease, even when there are multiple risk factors.

    This near-90% drop in events like heart attacks or sudden death occurred at an average LDL level of 100 mg/dL, compared to 138 mg/dL in those without the genetic mutation. This means LDL can drop below even 100 mg/dL. Why does a drop in LDL cholesterol by about 40 mg/dL from a lucky genetic mutation lower the risk of coronary heart disease by nearly 90%, while the same reduction with statin drugs lowers it by only about 20%? The most probable explanation? Duration. When it comes to lowering LDL cholesterol, it’s not only about how low it is, but how long it’s been low.

    That’s why healthy lifestyle choices may wipe out about 90% of our risk for having a heart attack, while drugs may reduce it by only 20% to 30%. If you’re getting treated with drugs later in life, you may have to get your LDL under 70 mg/dL to halt the progression of coronary atherosclerosis. But if we start making healthier choices earlier, it may be enough to lower LDL cholesterol just to 100 mg/dL, which should be achievable for most of us. That’s consistent with country-by-country data that suggested death from heart disease would bottom out at a population average of about 100 mg/dL, as seen below and at 5:21 in my video.

    But that’s only if you can keep your LDL cholesterol down your whole life.

    If you’re relying on medication later in life to halt disease progression, you may need to get your LDL below 70 mg/dL, and if you’re trying to use drugs to reverse a lifetime of bad food choices, you may not get to zero coronary heart disease events until your LDL drops to about 55 mg/dL. If your heart disease is so bad that you’ve already had a heart attack but you’re trying not to die from another one, ideally, you might want to push your LDL down to about 30 mg/dL. Once you get that low, not only would you likely prevent any new atherosclerotic plaques, but you’d also help stabilize the plaques you already have so they’re less likely to burst open and kill you.

    Is it even safe to have cholesterol levels that low, though? In other words, can LDL cholesterol ever be too low? We’ll find out next.

    Doctor’s Note

    Didn’t know atherosclerosis could start at such a young age? See Heart Disease Starts in Childhood.

    For more on drugs versus lifestyle, check out my video The Actual Benefit of Diet vs. Drugs.

    Want to learn more about so-called primordial prevention? See When Low Risk Means High Risk.

    Does Cholesterol Size Matter? Watch the video to find out.

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    Michael Greger M.D. FACLM

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  • This NICU nurse takes care of infants all while flying hundreds of feet in the air – WTOP News

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    Many nurses in the D.C. area are responsible for taking care of people struggling with severe illnesses, but only a few are doing it for the youngest patients, all while traveling over 100 miles per hour, hundreds of feet above the ground.

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    NICU nurse saves tiny lives midair

    In the D.C. region, conversations often start with, “What do you do?” WTOP’s “Working Capital” series profiles the people whose jobs make the D.C. region run.

    Many nurses in the D.C. area are responsible for taking care of people struggling with severe illnesses, but only a few are doing it for the youngest patients all while traveling over a 100 miles per hour, hundreds of feet above the ground.

    For the past 27 years, Janice Berry has been a neonatal intensive care unit transport nurse at Children’s National Hospital in D.C. She originally worked on the floor for about 12 years before turning in her scrubs for a navy blue flight suit.

    Berry joined the NICU at Children’s National in 1986 after attending nursing school at Clemson University.

    She has taken thousands of flights by helicopter all over the Capital region to pick up infants fighting for their lives.

    “Thankfully, with a helicopter, it really cuts a two-and-a-half-hour driving time down to about 40 minutes,” Berry said.

    On a typical day for the veteran nurse, she and her team will get a briefing from the pilots about the conditions of the aircraft as well as any weather issues that they may run into.

    They pack up the portable isolation box that NICU babies usually need, though theirs comes with a seat belt for the ride.

    “We generally have a basic idea of what’s going on with the baby, what kind of equipment, what size team that we’re going to need for that transport,” Berry told WTOP. “Sometimes, it’s just myself and a paramedic and either the driver or the pilot. Sometimes we’ll need respiratory therapy, and occasionally we’ll bring a doctor with us as well.”

    Additional nurses, breathing specialists and physicians take the ride, depending on the case.

    While most NICU nurses deal with their patients’ health complications, Berry and other transport nurses have the added complication of performing their care for the infants while flying through the air and dealing with turbulence.

    As well as a nurse, Berry is part safety officer, having learned extensively about flying during her time.

    “When we’re on the aircraft, we’re looking out for any potential problems. All of us are part of that team that helps keep this patient safe and are able to mitigate those safety concerns,” she said.

    If the weather is detrimental to flying and could cause any safety concerns, they will take an ambulance instead of the usual helicopter that you may see zipping around the D.C. skies.

    “Once I got here and I saw what the transport team did, and how they functioned, and everything that they got to do — which is a really unique job — that was what my goal was and what I strived for,” Berry said.

    After a number of years of bedside nursing, she took the position on the transport team.

    “I really appreciate that it’s different every day,” Berry said.

    “Since we are based in the NICU, I go out as a children’s nurse, meet the families, talk to them about Children’s (National) and the wonderful care that we’re going to give this baby, and help to reassure them. Because generally, this is not a normal birth plan for anyone to have their child transported right after delivery,” she added.

    Following up with the families is one of her favorite parts of the job.

    “I was invited to a first birthday party recently for someone I transported, which was pretty amazing to get to see that full circle moment of my little guy doing great,” Berry said.

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    Luke Lukert

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  • Read labels, ask doctors: How to give Tylenol to your child

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    It isn’t often that President Donald Trump issues parenting advice. But in late-September, he repeatedly warned parents to stop giving Tylenol to young children. 

    “When you have your baby, don’t give your baby Tylenol at all unless it’s absolutely necessary,” he said during a Sept. 22 press conference focused on the administration’s actions to address increasing autism diagnoses.

    Trump’s recommendation is at odds with medical research, pediatric advice and U.S. public health guidance. During the same Sept. 22 remarks, Trump told pregnant mothers to avoid taking Tylenol because of what he described as a risk that its active ingredient acetaminophen could cause autism in their children. That’s scientifically unproven, and there’s no proof of a connection between childhood acetaminophen use and autism either.

    Trump’s statements may leave parents newly uncertain about how to respond when their children have fevers or pain. Pediatricians told us that Tylenol is safe for children when taken as directed. Parents should always read medicine labels, consult their doctors and take measures to make sure they are administering acetaminophen as indicated and in its appropriate doses. 

    Here are answers to some basic questions: 

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    What is acetaminophen?

    Acetaminophen is widely used to reduce pain and fever. It is an active ingredient in some brand-name over-the-counter medications including Tylenol, Dayquil, Dimetapp, Robitussin and Sudafed. It has some risks, and those risks have made headlines: Too much acetaminophen can cause overdose and severe liver damage.

    Acetaminophen does not reduce inflammation, unlike over-the-counter pain relievers such as ibuprofen, which is found in Advil and Motrin, and naproxen, found in Aleve. Those inflammation reducers are known as nonsteroidal anti-inflammatory drugs, often referred to as NSAIDs.

    What do doctors say about acetaminophen’s safety?

    Acetaminophen is safe, doctors say, when taken as recommended and under a pediatrician’s guidance. This finding is supported by decades of research. 

    Soon after Trump’s statements, the American Academy of Pediatrics affirmed acetaminophen’s safety when taken as directed and turned to social media to get the word out. “There is no causal link between acetaminophen and autism,” it wrote on Facebook

    Pediatricians echo that message.

    Babies under 3 months old have immature immune systems, so parents should talk to their doctors before administering any medication, UC Davis Health’s Children’s Hospital pediatrician Dr. Lena van der List said. Once babies reach 3 months, parents should be able to give them acetaminophen for moderate pain and to reduce fevers of 100.4 F or higher. 

    “Used with proper guidance and for the correct indications, Tylenol has a place in routine pediatric care,” said Dr. Flor Muñoz, Baylor College of Medicine associate professor of pediatrics and infectious diseases.

    How can I make sure I am giving Tylenol appropriately to my child?

    Read ingredient labels on over-the-counter medications. Don’t combine medications that, taken together, exceed the appropriate doses of acetaminophen. Measure medicine using marked medicine cups or syringes. When giving acetaminophen orally, don’t give more than four doses in 24 hours. 

    Even in adults, using multiple acetaminophen-containing products such as cough medicine, menstrual relief medication or headache medicine can lead to overdoses, Rand said. 

    “It’s a great idea to keep a log of the date and times the medication was administered,” van der List said.

    How do I decide if acetaminophen is the right call? 

    Evaluate how sick your child looks, feels and behaves. 

    “If your child has a fever but is still able to sleep, drink fluids to stay hydrated and is generally comfortable — then it’s O.K. to forgo fever-reducing medications, such as acetaminophen,” van der List said. 

    Children should see a doctor for any fever that persists for five days. If you don’t have a clear reason for administering the medication, avoid giving it to a child over a longer period. 

    “If it’s a fever, great, that’s an appropriate use for acetaminophen,” van der List said. “If it’s vague symptoms, like your infant waking up nightly crying for weeks that you have attributed to ‘teething pain,’ this may be a time to check in with your health care provider as there may be something aside from pain contributing.”

    Has the federal government changed its guidance on acetaminophen’s safety for children? 

    Official public health communications remained the same as before Trump’s comments, as of Oct. 3. The U.S. Food and Drug Administration describes acetaminophen as “safe and effective when used as directed.” Health officials from the FDA and Health and Human Services Department have not announced actions related to childhood acetaminophen use. 

    Medline Plus, a website that is part of the National Institutes of Health’s National Library of Medicine and that provides advertising-free health information, echoes the FDA when describing acetaminophen dosage for children. It recommends checking with a physician before giving acetaminophen to children under 2 years old and advises reading drug labels to determine the appropriate dosages based on children’s weight. 

    Apart from a Trump Truth Social post, the administration’s written communication has focused on acetaminophen use during pregnancy. When we asked the White House and HHS if its official guidance is that children should not take acetaminophen, the agency did not answer that question.

    Are there any risks if I don’t give my feverish child acetaminophen? 

    There can be risks, yes. Children who have high fevers and significant pain from a sore throat, for example, are at risk of becoming dehydrated without adequate treatment. 

    “Dehydration is serious and if severe enough can lead to organ damage,” van der List said. “Dehydration may require hospitalization for intravenous fluids and management of electrolyte changes, hypoglycemia and organ dysfunction.”

    Rand said that from about the age of 6 months to 5 years old, fevers can cause febrile seizures in about 3% to 4% of children. Such seizures usually last less than one to two minutes; they can be frightening, but they don’t typically lead to long-term complications.

    “If this occurs, you should contact a doctor for evaluation but also treat the fever to make the child more comfortable,” Rand said.

    Is there anyone who shouldn’t take acetaminophen? 

    People with liver disease or hepatitis can’t process acetaminophen very easily, making them more vulnerable to liver damage from the medication. 

    In rare cases, acetaminophen can cause serious skin reactions, Stevens-Johnson Syndrome and acute generalized exanthematous pustulosis. Symptoms include red skin, rash and blisters. If a skin reaction occurs when your child is taking an acetaminophen-containing medication, the FDA advises that you stop using that medication and seek medical attention immediately. People who have had a serious skin reaction after taking acetaminophen should avoid the medication going forward, the agency said.

    People with acetaminophen allergies should also avoid taking the drug.

    Trump warned parents against giving Tylenol with vaccines. Is this something I should avoid?

    After a vaccine, acetaminophen might be warranted to treat symptoms such as fever, discomfort or irritability and persistent crying that signal pain, Muñoz said.

    But Rand said parents should avoid giving it to a child before the vaccine is given. “There is some evidence to show it may reduce the immune response,” she said. 

    Does taking acetaminophen increase my child’s risk of autism?

    No research shows taking acetaminophen as a child causes increased risk of autism. A 2021 study in the European Journal of Epidemiology looking into the matter did not find an association between exposure to acetaminophen after a child is born and autism.

    Researchers say that there is no single factor that can explain all autism diagnoses. Autism is a complex neurological condition that influences how someone acts and communicates. Research signals that genetics play a significant role in the likelihood someone will have autism.

    Higher paternal age and maternal use of a drug called valproate, which is used to treat epilepsy and bipolar disorder, increases risk, research has found. Low birth weights and a mother’s fever or illness during pregnancy have also been linked to autism, the Autism Science Foundation said. 

    A 2022 European Journal of Pediatrics review of existing research concluded that acetaminophen “has been proven safe for liver function in infants and in small children, even at doses higher than those currently recommended,” but was “never shown to be safe for neurodevelopment.” It did not prove acetaminophen was unsafe for neurodevelopment.

    RELATED: RFK Jr.’s statements about autism and environmental toxins conflict with ample research

    RELATED: Research doesn’t show using Tylenol during pregnancy causes autism. Here’s what else you should know

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  • 5 parenting practices that have changed since you were a baby

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    (CNN) — Parenting is not for the faint of heart. It can take new parents a beat or two to fully tune in to what their baby’s cries could mean. So many small but consequential decisions need to be made on a daily, if not hourly, basis. There are also questions. Many questions.

    At a time when misinformation abounds, pediatrician Dr. David Hill is the calm voice of reassurance and reason, grounded in science. He encourages new parents to ask their baby’s pediatrician questions, including about any advice they find on the internet.

    “People come to me with stuff all the time,” Hill said, noting the importance of forging a solid parent-pediatrician relationship. That trust, he said, is what’s “going to steer us through this swamp of misinformation and disinformation that’s out there right now.”

    Hill is a father of five in a blended family who has been in practice for more than 25 years. He has been the associate medical editor of the American Academy of Pediatrics’ book “Caring for Your Baby and Young Child: Birth to Age 5, 8th edition,” and is slated to be the editor-in-chief for the next edition. He also cohosts the academy’s podcast “Pediatrics On Call.”

    “The question I get the most often from new parents, and even those who have been at it for a while is, is this normal?” Hill told CNN Chief Medical Correspondent Dr. Sanjay Gupta recently on his podcast, Chasing Life.

    “As somebody who’s seen probably over 10,000 children … it is a joy for me to almost always be able to reassure, and be like, ‘Yeah. That’s fine. They do that. Kids do a lot of weird things, and they do a lot of things at their own pace,” Hill said. “Normal can be all over the map.”

    You can listen to the podcast’s full episode here.

    Hill said he strongly urges parents to seek out trusted, reliable sources for guidance. “Sources of information that have been validated, that use real data,” he said. “And honestly, talk to your child’s doctor — develop that relationship, because that’s what we’ve dedicated our lives to doing.”

    Hill works closely with the AAP on the organization’s parent-facing information. “I do that because I know, over decades of experience, how dedicated everybody in that group is to making sure we get this right, including being willing to get egg on our faces and say, ‘You know what? We were wrong,’ when we were wrong,” Hill said. “And that’s really critical. Anybody who’s never wrong, I don’t trust, because none of us is perfect.”

    During the decades Hill has been in practice, he has witnessed some of the babies he saw at the start of his career become parents themselves. During that time, he has also watched the science of child health evolve.

    “What I tell these new parents is sometimes the complete opposite of what I said when they were babies!” he said via email.

    Here are the five biggest changes Hill has seen over his career.

    Safe sleep practices

    Sleep guidelines literally flipped in 1994, when Hill finished medical school. That year, the National Institute of Child Health and Human Development launched the first “Back to Sleep” campaign urging parents to put their baby to sleep on their back. Before then, parents had been told to put an infant to sleep on the belly to avoid aspiration.

    But that’s not all. The US Consumer Product Safety Commission banned drop-side cribs from the marketplace in 2011 and warned against inclined sleepers in 2019, Hill said. And the Safe Sleep for Babies Act, signed into federal law in 2022, outright banned the sale of drop-side cribs and crib bumpers that could potentially suffocate infants.

    He noted that in 1990, there were 154 sudden unexpected infant deaths per 100,000 babies, a number that fell 44% to a low of 86 in 2011. (It has since gone up to 100 deaths per 100,000 in 2022).

    “While some of those deaths are from mysterious or unavoidable causes,” he said, “many could still be prevented by following all the safe sleep guidelines, including not only placing infants on their backs to sleep, but never co-sleeping (and) avoiding soft bedding.”

    Advice to prevent food allergies

    Complete avoidance is out, and small exposures are in.

    “I still remember in 2015 searching all the drawers in our practice for outdated infant feeding handouts that, if parents followed them, could put their babies at increased risk of developing life-threatening food allergies,” Hill said. “These handouts told parents to avoid giving their infants and toddlers anything containing peanuts or eggs until they turned at least 2 years old, even 3 if they had eczema or a family history of allergies.”

    But, Hill said, in 2015, the results of the LEAP trial confirmed what some earlier studies had suggested: “That it wasn’t early peanut exposure that had caused a doubling of peanut allergies in the preceding decade. It was the advice in these handouts!” he said.

    Now parents and guardians are advised to introduce peanut-containing products and eggs along with other solid foods in the first year of life, as soon as babies are safely taking solids, usually around 6 months of age.

    Preventing babies from having any exposure to potential allergens apparently left their immune systems oversensitive when they finally did encounter them later on.

    Umbilical cord care

    Umbilical cords used to be treated with a messy (for doctors) purple “triple” dye — an antiseptic to keep bacterial infections at bay. Now, the recommendation in well-resourced countries and communities is to let the cord dry on its own — and to keep a close eye on it.

    “The purpose of the dye was to prevent potentially dangerous infections of the umbilical cord and surrounding tissues (omphalitis),” Hill said. “Then, a few brave souls, perhaps fed up with their dry-cleaning bills, decided to see what would happen if we used alcohol instead of the dye. It turned out … nothing.”

    Hill said the next step was to just let the cord dry on its own, taking care not to trap it in a wet or soiled diaper for extended periods and to avoid soaking it at bathtime. That practice is where the guidance stands today.

    Some known risk factors for omphalitis, Hill said, include low birth weight, prolonged rupture of membranes or prolonged labor, maternal infection, nonsterile delivery or home birth, and improper cord care.

    “If you see the skin around the belly button turning red or notice an unusually foul discharge, get your baby seen,” he advised.

    What about bathing? Should new parents avoid baths until the cord falls off? “Advice on this one varies, but it’s not clear there’s any more danger from a brief immersion than from a sponge bath,” he said.

    New and better vaccines

    The vaccination schedule for infants and children has been updated throughout the years as new shots become available, offering better protection against childhood scourges.

    “My dad is also a pediatrician, and I grew up hearing horror stories of babies suffering from meningitis and sepsis. It seems my dad was always dashing off to the hospital to perform spinal taps,” Hill recalled. “This started to change, however, in 1985, when a vaccine against Haemophilus influenza B, one of the most dreaded infections of childhood, came out.

    “In training and early in my career, I saw awful infections from another bacteria, pneumococcal pneumonia. These infections became much rarer in 2000, when the first pneumococcal vaccine for children came out,” he said. “Since then, that vaccine has expanded from covering seven subtypes of pneumococcus to covering as many as 23.”

    Just in the past year, Hill said he witnessed another infantile infection he dreaded, RSV, or respiratory syncytial virus, plummet in frequency and severity thanks to both vaccines for expectant mothers and antibody injections for babies.

    Considering the big picture

    Another change involves a paradigm shift in the way pediatricians think about health and well-being, Hill said.

    “In pediatrics, one of those tectonic shifts hit in 1998, the year I started practice and the year the ACEs Study came out,” he said, referring to a study that looked at adverse childhood experiences. Those potentially traumatic events include physical, emotional and/or sexual abuse; the death of a parent; mental illness; or violence or substance abuse in the household, any of which can create toxic stress in a child, leading to changes in brain development and affecting future mental, physical and emotional health.

    “Many people had noticed that traumatic events in childhood … seemed to impact later health,” Hill said. “The ACEs Study measured and quantified the extent and duration of these effects, and the results were more dramatic and longer-lasting than anyone had guessed.”

    An explosion of research followed, Hill said, which led to a new approach in pediatrics.

    “Every child faces stressful events, some severe enough to impact their health. But the safe, stable, nurturing relationships that children build with the adults around them can protect them,” he explained. “Understanding these interactions inspires trauma-informed care, an effort to work with families to address the stresses in their lives and to build those emotional connections that can help their children thrive.”

    Under this approach, Hill said, pediatricians pivoted from asking “What’s wrong with you?” to asking “What happened to you, and how can we help?”

    “A key concept here is the ‘good enough parent,’” he said. “No parent is perfect, but perfection is not required to be safe, stable, and nurturing.”

    As a parent himself, Hill said that thought “brings me a sigh of relief.”

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    Andrea Kane and CNN

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  • Epigenetics and Obesity  | NutritionFacts.org

    Epigenetics and Obesity  | NutritionFacts.org

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    Identical twins don’t just share DNA; they also share a uterus. Might that help account for some of their metabolic similarities? “Fetal overnutrition, evidenced by large infant birth weight for gestational age, is a strong predictor of obesity in childhood and later life.” Could it be that you are what your mom ate?

    A dramatic illustration from the animal world is the crossbreeding of Shetland ponies with massive draft horses. Either way, the offspring are half pony/half horse, but when carried in the pony uterus, they come out much smaller, as you can see below and at 0:47 in my video The Role of Epigenetics in the Obesity Epidemic. (Thank heavens for the pony mother!) This is presumably the same reason why the mule (horse mom and donkey dad) is larger than the hinny (donkey mom and horse dad). The way you test this in people is to study the size of babies from surrogates after in vitro fertilization. 

    Who do you think most determines the birth weight of a test-tube baby? Is it the donor mom who provided all the DNA or the surrogate who provided the intrauterine environment? When it was put to the test, the womb won. Incredibly, a baby who had a thin biological mother but was born to a surrogate with obesity may harbor a greater risk of becoming obese than a baby with a heavier biological mother but born to a slim surrogate. The researchers “concluded that the environment provided by the human mother is more important than her genetic contribution to birth weight.”

    The most compelling data come from comparing obesity rates in siblings born to the same mother, before and after her bariatric surgery. Compared to their brothers and sisters born before the surgery, those born when mom weighed about 100 pounds less had lower rates of inflammation, metabolic derangements, and, most critically, three times less risk of developing severe obesity—35 percent of those born before the weight loss were affected, compared to 11 percent born after. The researchers concluded that “these data emphasize how critical it is to prevent obesity and treat it effectively to prevent further transmission to future generations.”

    Hold on. Mom had the same DNA before and after surgery. She passed down the same genes. How could her weight during pregnancy affect the weight destiny of her children any differently? Darwin himself admitted, “In my opinion, the greatest error which I have committed, has been not allowing sufficient weight to the direct action of the environment, i.e. food…independently of natural selection.” We finally figured out the mechanism by which this can happen—epigenetics.

    Epigenetics, which means “above genetics,” layers an extra level of information on top of the DNA sequence that can be affected by our surroundings, as well as potentially passed on to our children. This is thought to explain the “developmental programming” that can occur in the womb, depending on the weight of the mother—or even the grandmother. Since all the eggs in your infant daughter’s ovaries are already preformed before birth, a mother’s weight status during pregnancy could potentially affect the obesity risk of her grandchildren, too. Either way, you can imagine how this could result in an intergenerational vicious cycle where obesity begets obesity.

    Is there anything we can do about it? Well, breastfed infants may be at lower risk for later obesity, though the benefits may be confined to those who are exclusively breastfed, as the effect may be due to growth factors triggered by exposure to the excess protein in baby formula, as you can see below and at 3:51 in my video. The breastfeeding data are controversial, though, with charges leveled of a “white hat bias.” That’s the concern that public health researchers might disproportionally shelve research results that don’t fit some goal for the greater good. (In this case, preferably publishing breastfeeding studies showing more positive results.) But, of course, that criticism came from someone who works for an infant formula company. Breast is best, regardless. However, its role in the childhood obesity epidemic remains arguably uncertain.

    Prevention may be the key. Given the epigenetic influence of maternal weight during pregnancy, a symposium of experts on pediatric nutrition concluded that “planning of pregnancy, including prior optimization of maternal weight and metabolic condition, offers a safe means to initiate the prevention rather than treatment of pediatric obesity.” Easier said than done, but overweight moms-to-be may take comfort in the fact that after the weight loss in the surgery study, even the moms who gave birth to kids with three times lower risk were still, on average, obese themselves, suggesting weight loss before pregnancy is not an all-or-nothing proposition.

    What triggered the whole obesity epidemic to begin with? There are a multitude of factors, and I covered many of them in my 11-video series on the epidemic in the related posts below.

    We are what our moms ate in other ways, too. Check out: 

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    Michael Greger M.D. FACLM

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  • Infants’ tongue-tie may be overdiagnosed and needlessly treated, American Academy of Pediatrics says

    Infants’ tongue-tie may be overdiagnosed and needlessly treated, American Academy of Pediatrics says

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    Tongue-tie —a condition in infants that can affect breastfeeding — may be overdiagnosed in the U.S. and too often treated with unnecessary surgery, a prominent doctors’ group said Monday.Video above: Why microwaving baby food might be causing more harmThe American Academy of Pediatrics is the latest, and largest, medical society to sound an alarm about the increasing use of scissors or lasers to cut away some infants’ tongue tissue when breastfeeding is difficult.”It’s almost an epidemic,” said Dr. Maya Bunik, a Colorado-based co-author of the report.Experts say there isn’t a good count of how many infants each year are being treated for tongue-tie with surgery, though Bunik believes the annual tally may exceed 100,000. Research suggests many of those treatments are not necessary, she added.The academy’s new report encourages pediatricians and other medical professionals to consider nonsurgical options to address breastfeeding problems. The report cites a study that suggests less than half of the kids with the characteristics of tongue-tie actually have difficulty breastfeeding.Ankyloglossia, or “tongue-tie,” occurs when an infant is born with a tight or short band of tissue that tethers the bottom of the tongue’s tip to the floor of the mouth. The condition can make it hard for the infant to extend and lift their tongue to grasp a nipple and draw milk — which in turn can be painful for the mother.Doctors say it’s critical to get breastfeeding on track in the first three to four weeks, and surveys indicate most parents want to breastfeed, so it’s natural that they want a quick solution to a problem, Bunik said.Ankyloglossia diagnoses have been increasing worldwide, though there is no uniform diagnostic criteria for this condition and no consensus on how to treat it. One common approach is to cut the tissue with scissors, but dentists increasingly are using lasers to vaporize the tissue — some charging $800 or more.But the procedures can cause pain and sore mouths, potentially deterring babies from trying to breastfeed, Bunik said.”The practice (of treating tongue-tie) got to be very common without a lot of good data,” said Wisconsin pediatrician Dr. Jennifer Thomas, who also co-authored the report.The report also recommends lactation experts, pediatricians and surgeons and other medical professionals work with parents to evaluate possible reasons for breastfeeding challenges and make the best treatment decision.The American Academy of Pediatrics, which has 67,000 members who specialize in treating children, started working on the report in 2015 after some pediatricians began to notice that an increasing number of patients were going to dentists to get treatment for tongue-tie, Thomas said. Pediatricians were finding out after the surgeries.At least two other medical groups have issued statements about tongue-tie. In 2020, the American Academy of Otolaryngology-Head and Neck Surgery issued a consensus statement in which member physicians said they believe tongue-tie is being overdiagnosed in some places and that there isn’t sufficient evidence to support claims that using lasers is superior to other techniques.A year later, the Academy of Breastfeeding Medicine, an international group, issued a position called for more research into tongue-tie treatment and stressed that decisions “require a high level of clinical skill, judgment, and discernment.”The American Dental Association didn’t directly respond to The Associated Press’ questions about the new report. It sent a statement saying the organization agrees with a 2022 policy statement by the American Academy of Pediatric Dentistry, which noted not all children with ankyloglossia need surgical intervention and that a team-based approach with other specialists can aid in treatment planning.Haley Brown saw a lactation consultant two years ago after her son Shiloh, who was born prematurely, had trouble nursing. But as months passed and the situation didn’t improve, Brown turned to a Denver dentist she heard about on social media The dentist diagnosed Shiloh with tongue-tie and also lip-tie, in which the tissue inside the upper lip is too tight. Shiloh underwent a short laser procedure that cost $750.Breastfeeding improved immediately. “Things just seemed a little easier for him,” said Brown, 33, of Englewood, Colorado.Brown later had another baby, and another lactation consultant told her that a scissors snip could have been less involved and just as effective. Brown said the laser treatment worked for Shiloh, but added: “I probably should have consulted with my pediatrician before I went straight to the dentist.”

    Tongue-tie —a condition in infants that can affect breastfeeding — may be overdiagnosed in the U.S. and too often treated with unnecessary surgery, a prominent doctors’ group said Monday.

    Video above: Why microwaving baby food might be causing more harm

    The American Academy of Pediatrics is the latest, and largest, medical society to sound an alarm about the increasing use of scissors or lasers to cut away some infants’ tongue tissue when breastfeeding is difficult.

    “It’s almost an epidemic,” said Dr. Maya Bunik, a Colorado-based co-author of the report.

    Experts say there isn’t a good count of how many infants each year are being treated for tongue-tie with surgery, though Bunik believes the annual tally may exceed 100,000. Research suggests many of those treatments are not necessary, she added.

    The academy’s new report encourages pediatricians and other medical professionals to consider nonsurgical options to address breastfeeding problems. The report cites a study that suggests less than half of the kids with the characteristics of tongue-tie actually have difficulty breastfeeding.

    Ankyloglossia, or “tongue-tie,” occurs when an infant is born with a tight or short band of tissue that tethers the bottom of the tongue’s tip to the floor of the mouth. The condition can make it hard for the infant to extend and lift their tongue to grasp a nipple and draw milk — which in turn can be painful for the mother.

    Doctors say it’s critical to get breastfeeding on track in the first three to four weeks, and surveys indicate most parents want to breastfeed, so it’s natural that they want a quick solution to a problem, Bunik said.

    Ankyloglossia diagnoses have been increasing worldwide, though there is no uniform diagnostic criteria for this condition and no consensus on how to treat it. One common approach is to cut the tissue with scissors, but dentists increasingly are using lasers to vaporize the tissue — some charging $800 or more.

    But the procedures can cause pain and sore mouths, potentially deterring babies from trying to breastfeed, Bunik said.

    “The practice (of treating tongue-tie) got to be very common without a lot of good data,” said Wisconsin pediatrician Dr. Jennifer Thomas, who also co-authored the report.

    The report also recommends lactation experts, pediatricians and surgeons and other medical professionals work with parents to evaluate possible reasons for breastfeeding challenges and make the best treatment decision.

    The American Academy of Pediatrics, which has 67,000 members who specialize in treating children, started working on the report in 2015 after some pediatricians began to notice that an increasing number of patients were going to dentists to get treatment for tongue-tie, Thomas said. Pediatricians were finding out after the surgeries.

    At least two other medical groups have issued statements about tongue-tie. In 2020, the American Academy of Otolaryngology-Head and Neck Surgery issued a consensus statement in which member physicians said they believe tongue-tie is being overdiagnosed in some places and that there isn’t sufficient evidence to support claims that using lasers is superior to other techniques.

    A year later, the Academy of Breastfeeding Medicine, an international group, issued a position called for more research into tongue-tie treatment and stressed that decisions “require a high level of clinical skill, judgment, and discernment.”

    The American Dental Association didn’t directly respond to The Associated Press’ questions about the new report. It sent a statement saying the organization agrees with a 2022 policy statement by the American Academy of Pediatric Dentistry, which noted not all children with ankyloglossia need surgical intervention and that a team-based approach with other specialists can aid in treatment planning.

    Haley Brown saw a lactation consultant two years ago after her son Shiloh, who was born prematurely, had trouble nursing. But as months passed and the situation didn’t improve, Brown turned to a Denver dentist she heard about on social media The dentist diagnosed Shiloh with tongue-tie and also lip-tie, in which the tissue inside the upper lip is too tight. Shiloh underwent a short laser procedure that cost $750.

    Breastfeeding improved immediately. “Things just seemed a little easier for him,” said Brown, 33, of Englewood, Colorado.

    Brown later had another baby, and another lactation consultant told her that a scissors snip could have been less involved and just as effective. Brown said the laser treatment worked for Shiloh, but added: “I probably should have consulted with my pediatrician before I went straight to the dentist.”

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  • To help parents facing adversity nurture their children, a Delaware prof created a program now used by 10 countries

    To help parents facing adversity nurture their children, a Delaware prof created a program now used by 10 countries

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    A young mother sits on the floor in a motel room with her baby girl on her lap, her son milling around in the background. The mother taps the infant’s fist on a toy, as the baby dazes blankly, unengaged. 

    These moments were captured on video before the mother underwent a 10-session intervention for parents who have trouble bonding with their children because of challenges tied to poverty, homelessness and other issues. In a montage of clips filmed afterward, the woman can be seen snuggling the baby sleeping on her chest while she talks to and plays with her young son at her side. In another clip, the son dangles his arm around his mother’s shoulders as she jostles the baby in her lap.


    There is life and love in the room.

    “This mom continues to live in a motel room,” said Mary Dozier, a professor of psychological and brain sciences at the University of Delaware who developed the program. “We haven’t helped her with child care. We haven’t helped her with housing. We haven’t directly tried to change depression or anything else, and yet, these two children’s lives have fundamentally changed.”

    Dozier has spent three decades studying the development of infants and young children. The home visiting program that she developed, dubbed ABC for Attachment and Biobehavioral Catch-Up, uses coaches who provide in-the-moment positive reinforcement to help parents learn to nurture a child, follow a child’s lead and avoid frightening behaviors. These skills are useful for anybody, but they are “especially important when children have experienced adversity or trauma,” Dozier said.

    Through a series of studies coordinated with the Philadelphia Department of Health and Human Services, Dozier and a team of researchers identified children who were at risk of neglect and have followed their development for 15 years, examining the short- and long-term effects of the ABC program. This research has shown that the ABC program – now used in 26 states and 10 countries – improves children’s brain and behavioral development and helps them gain trusting, secure relationships with their parents. Studies have indicated that the easily-implemented ABC program improves children’s executive-functioning and self-control and that it regulates cortisol production, the stress-hormone that partly affects sleep.

    “We see this everywhere we go, whether it’s when we implement it nationally and internationally or in a randomized trial,” said Dozier, the UNIDEL Amy E. du Pont Chair of Child Development at the University of Delaware. “We see the parents change. They become more sensitive. They follow the lead more of their child. We see the children’s attachment is more likely to be secure and organized.”

    Currently, Dozier and her team have been researching how the ABC program impacts parents with substance use disorder. The $3.1 million, National Institutes of Health-funded study began in 2020 and ends in 2026. It includes about 200 parents from Pennsylvania, New Jersey, Delaware and Maryland who are receiving treatment, such as the medications methadone or buprenorphine that help stem the cravings for and effects of opioids. Since opioids and other drugs interfere with brain receptors involved with the reward system, the natural rewards that come from bonding with a child and parenting may be affected.

    “We (humans) are designed so that parenting will be rewarding, but that system gets disrupted when we have enough challenges in our life, either because of drugs or mental health issues or living in a motel room with three kids,” Dozier said. “So what you’ve got to do is change the system, tweak it so that eventually children can be become more rewarding, so that the process of parenting is itself rewarding.”

    With the parents with substance use disorder in the ABC program, Dozier’s team has been placing electrodes on their heads to study brain activity as they look at pictures of babies and pictures of drugs.

    “What we anticipate is that the baby would become relatively more important to them than the drug, if they’re in the … ABC intervention than if they’re not,” Dozier said. “But I don’t know the answer to that at this point.”

    Helping parents learn to become more engaged with their children is necessary even before resolving substance use, stabilizing housing or addressing other challenges because “babies can’t wait,” Dozier said.

    No matter what situation the parents are in, coaches conducting the ABC intervention do not critique or correct parents’ actions. Instead, starting in the very first session, the coaches “are already trying to find something in what they’re (the parents) doing that is positive and pointing it out,” Dozier said.

    The parent should feel supported by the ABC coach whose ongoing, positive reinforcement of what the parent is doing well elicits a “cascade of behaviors, and it makes parents really feel empowered. It makes them feel good about themselves,” Dozier said.

    “I was 37, and I was a psychologist when I had my first child,” Dozier said. “If you had an expert come in to say they’re going to evaluate my parenting, I would have found that threatening. And so you can imagine what it would feel like for a 20-year-old who is using opioids.

    “Everybody said, ‘How in the world could you possibly have a child? You have no business having a child.’ They’re (the parents) going to just feel so demeaned. So, the positive comments are just so critical in helping them feel rewarded by this process. And eventually, what we want is that they are rewarded by their baby and rewarded by parenting itself. We’re sort of scaffolding that process to get them to that point.”

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    Courtenay Harris Bond

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  • Baby drowns in bath while mom was on phone for 20 minutes: Sheriff

    Baby drowns in bath while mom was on phone for 20 minutes: Sheriff

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    A Michigan mother was arrested Thursday on felony charges in connection to her 8-month-old son’s drowning death last year when the baby was left alone in a bathtub while she was on the phone for more than 20 minutes, according to the local sheriff’s office.

    Olivia Miller, 23, of Sparta Township, Michigan, is facing one count of homicide — involuntary manslaughter and one count of second-degree child abuse in the November 2023 death of her 8-month-old son, Asher Johnson, court records show.

    Investigators determined that Miller was home alone with her baby when the boy drowned and said that the mother told varying accounts of what happened, according to a statement by the Kent County Sheriff’s Office (KCSO).

    Newsweek reached out via email on Saturday to KCSO and Miller’s attorney Frank Stanley for comment.

    Miller is currently being held on a $300,000 bond at the Kent County jail, online records show. She appeared for her arraignment on Friday where she pleaded not guilty to all charges, according to local station WZZM.

    Olivia Miller, 23, of Sparta Township, Michigan, was arrested and is facing charges of involuntary manslaughter and second-degree child abuse in the death of her infant son, Asher Joseph Johnson, who drowned in a bathtub…


    Kent County Sheriff’s Office

    On November 22, 2023, KCSO deputies, Sparta Police Department (SPD) officers and paramedics responded to a home off 16 Mile Road in Sparta Township for a call regarding a baby who had drowned in a bathtub, the sheriff’s office said.

    Miller was the only one home with her baby when she left him unattended in a bathtub with the water running, KCSO Deputy Anna Birkeland wrote in a probable-cause affidavit obtained by Michigan news website MLive.

    “Throughout the investigation, Olivia gave varying stories of what occurred surrounding Asher’s death,” Birkeland wrote.

    The mother told investigators that she left her baby, sitting up in the bathtub that was filled a few inches and had the water running, for five minutes while she went to the laundry room. When she returned, Miller said she found Johnson floating, with his face underwater, according to the affidavit.

    Miller said that she tried to revive her baby until first responders arrived, the court document states.

    During the investigation, detectives analyzed Miller’s cellphone activity around the time of her son’s death and found that she used her phone from 3:17 p.m. until she called 911 at 3:38 p.m. During that timeframe, there was only an 18-second break in her phone usage, the court documents state.

    Two minutes before she called 911, Miller called the baby’s paternal grandmother twice to tell her the boy had drowned.

    Four minutes before she called 911, she texted her father that she was “Just trying to talk while I have time while Asher’s taking a nap,” according to the affidavit.

    SPD arrived at the scene seven minutes after Miller called 911 and found the baby lying face-up on the living room floor. Officers attempted life-saving measures before the boy was taken to Helen DeVos Children’s Hospital where he was pronounced dead, court records state.

    The baby’s cause of death was determined to be drowning, according to an autopsy conducted by Kent County’s Chief Medical Examiner Stephen Cohle, who also estimated that the infant had been lying on his back on the floor for a minimum of 20 minutes before authorities arrived.

    Miller’s attorney told WZZM that there was “no indication of intentionality” regarding the mother’s alleged actions.

    “There’s no indication of intentionality here and that’s important to point out, Stanley said. “This is a tragic situation she suffered tremendously, emotionally from the death of her child. She loves that child. I’ve been inside that house. There are photographs all over that house of her, the father with that child.”

    Miller is due back in court on February 7.