Breastfeeding makes for more intelligent children
May 6, 2008
Child Health News
While it has been recognised for decades that breastfeeding is better for both mothers and babies, scientists are now suggesting that it also benefits a child’s intelligence.
In one of the most comprehensive studies conducted to date on breast feeding, the researchers say breastfed babies are more intelligent.
In a study involving 14,000 children living in Belarus who were monitored from birth to over six years, it was found that breastfed babies were more intelligent than those weaned on formula milk.
The findings which were based on IQ and academic ratings at age six, show that those who were breastfed performed significantly better in IQ tests.
The researchers found that by age six and a half, children who had been exclusively breastfed scored 7.5 points higher in verbal intelligence tests and 5.9 points higher in overall IQ tests - this was supported by their teachers who found that the breastfed children rated higher at reading, writing and solving mathematical problems.
Earlier research had reached the same conclusion but it raises the issue as to whether it is breast milk itself or the associated maternal care that is responsible for boosting the intelligence of developing babies and such an effect will be difficult to prove.
The problem lies with the fact that almost every study carried out to date has involved mothers deciding beforehand whether or not they plan to breastfeed and this then raises the possibility that breastfeeding women were simply brighter, or were likely to interact more with their children.
This latest study by researchers at McGill University in Montreal looked at children born at 31 maternity hospitals and clinics across Belarus between 1996 and 1997.
Professor Michael Kramer and his colleagues avoided the problems faced by earlier studies by randomly assigning half of the hospitals to adopt a breastfeeding promotion programme, while the rest acted as a control group and continued to offer their usual post-natal advice.
The doctors interviewed 13,889 of the children and their mothers between 2002-05, half of whom had attended clinics promoting breastfeeding.
Of mothers those mothers who visited clinics that advocated breastfeeding, 43% fed their babies only on breast milk until the age of three months, compared with 6.4% of women at the control clinics.
Professor Kramer says the study provides the strongest evidence to date that prolonged and exclusive breastfeeding makes children more intelligent.
However why or how breastfeeding boosts intelligence is a moot point - is it the due to some constituent of breast milk, or related to the physical and social interactions inherent in breastfeeding?
Experts say breast milk contains essential long-chain fatty acids and a chemical called insulin-like growth factor, which might be responsible for boosting intelligence.
The research is published in the Archives of General Psychiatry.
TV hinders mother-child interaction - limited verbal interactions
May 6, 2008
Child Health News
Infants who are exposed to television and video in low socio-economic households tend to have limited verbal interactions with their mothers, according to a new study led by Alan L. Mendelsohn, MD, Assistant Professor of Pediatrics and Director of Clinical Research for the divisions of General and Developmental-Behavioral Pediatrics in the Department of Pediatrics at NYU School of Medicine.
The study, published in the May issue of Archives of Pediatrics and Adolescent Medicine, is the first to assess parent-infant interactions as they relate to specific media content. Overall, parent-infant verbal interactions across broad media content were limited. When the programming was educational and co-viewed by both mother and infant in each other’s presence, interactions increased. However, the study showed that educational programming did not promote co-viewing, which is a factor that contributes to verbal interactions.
“Our conclusions are especially significant because parent-infant interactions have huge ramifications for early child development, as well as school advancement and success during adolescence,” says Dr. Mendelsohn, MD.
Because of its findings, the new study supports the recommendation from the American Academy of Pediatrics that television should be off limits to children under the age of two. Earlier data on this topic include a study by the Kaiser Family Foundation which cited that 61 percent of children younger than two years of age are exposed to television on a daily basis. In the new study, 97 percent of mothers with 6-month olds reported their infants were exposed to television or radio at the median rate of two hours a day.
The new study’s findings also have implications for health care providers who work with parents of young children, many of whom are exposed to television and videos, says Dr. Mendelsohn. The study advises that providers take good media histories. When infant television viewing is likely to continue, the study advises that parents expose their infants only to educational programming that is co-viewed by the mother. Dr. Mendelsohn notes the study also suggests that pediatricians increase efforts to promote verbal interactions with respect to media exposure and other daily activities, such as eating, playing and reading aloud.
Dr. Mendelsohn also underscores the critical importance of the study’s findings that the use of educational programming alone did not promote co-viewing, which is a factor in mother-infant interactions. “Our concern is that parents may still perceive educational programming as enough of a reason to park their infants in front of the television, instead of co-viewing and interacting with their infants,” says Dr. Mendelsohn. “Passive viewing does not lead to interaction between infant and mother.”
http://www.med.nyu.edu/
Breastfeeding may improve children’s IQ scores - other measures of cognitive development
May 6, 2008
Child Health News
Long-term, exclusive breastfeeding appears to improve children’s cognitive development, according to a report in the May issue of Archives of General Psychiatry.
Previous studies have reported that children and adults who were breastfed as infants have higher scores on IQ tests and other measures of cognitive (thinking, learning and memory) development than those who were fed formula, according to background information in the article. However, the evidence has been based on observational studies, in which children whose mothers chose to breastfeed were compared with those whose mothers chose not to breastfeed. The results of these studies may be complicated by subtle differences in the way breastfeeding mothers interact with their infants, the authors note.
Michael S. Kramer, M.D., of McGill University and the Montreal Children’s Hospital, Montreal, Quebec, and colleagues conducted a randomized trial of a breastfeeding promotion program involving patients at 31 maternity hospitals and affiliated clinics in Belarus. Between June 1996 and December 1997, clinics were randomly assigned either to adopt a program supporting and promoting breastfeeding or to continue their current practices and policies. A total of 7,108 infants and mothers who visited facilities promoting breastfeeding and 6,781 infants and mothers who visited control facilities received follow-up interviews and examinations between 2002 and 2007, when the children were an average of 6.5 years old.
Mothers who visited a facility promoting breastfeeding were more likely to feed their infants only breast milk at age 3 months (43.3 percent vs. 6.4 percent in the control group) and at all ages through 1 year. At age 6.5, the children in the breastfeeding group scored an average of 7.5 points higher on tests measuring verbal intelligence, 2.9 points higher on tests measuring non-verbal intelligence and 5.9 points higher on tests measuring overall intelligence. Teachers also rated these children significantly higher academically than control children in both reading and writing.
“Even though the treatment difference appears causal, it remains unclear whether the observed cognitive benefits of breastfeeding are due to some constituent of breast milk or are related to the physical and social interactions inherent in breastfeeding,” the authors write. Essential long-chain fatty acids and a compound known as insulinlike growth factor I, both found in breastmilk, could be responsible for the cognitive differences. On the other hand, the physical or emotional component of breastfeeding may lead to permanent changes affecting brain development. Breastfeeding also may increase verbal interaction between mother and child, which could improve children’s cognitive development.
“Although breastfeeding initiation rates have increased substantially during the last 30 years, much less progress has been achieved in increasing the exclusivity and duration of breastfeeding,” the authors conclude. “The consistency of our findings based on a randomized trial with those reported in previous observational studies should prove helpful in encouraging further public health efforts to promote, protect and support breastfeeding.”
http://archpsyc.ama-assn.org/
Strange barriers to physical activity may exist at child-care centers
May 6, 2008
Child Health News
At a time when over half of US children (aged 3-6) are in child care centers, and growing concern over childhood obesity has led physicians to focus on whether children are getting enough physical activity, a new study of outdoor physical activity at child care centers, conducted by researchers at Cincinnati Children’s Hospital Medical Center, has identified some surprising reasons why the kids may be staying inside.
The study, will be presented May 5 at the annual meeting of the Pediatric Academic Societies in Honolulu, Hawaii.
“It’s things we never expected, from flip flops, mulch near the playground, children who come to child care without a coat on chilly days, to teachers talking or texting on cell phones while they were supposed to be supervising the children,” according to Kristen Copeland, M.D., lead author of the study which was funded by the National Heart, Lung and Blood Institute. She noted that because there are so many benefits of physical activity for children - from prevention of obesity, to better concentration and development of gross motor skills - it’s important to know what barriers to physical activity may exist at child-care centers.
“With so many American preschool-aged children in child care centers, and previous reports that the amount of physical activity children get varies widely across different centers, we wanted to explore what some of the barriers to physical activity at these centers might be,” said Dr. Copeland, a physician scientist and Assistant Professor of Pediatrics in the Division of General and Community Pediatrics at Cincinnati Children’s. According to the most recent statistics 74% of US children aged 3-6 years are in some form of non-parental child care. 56% percent of 3-6 year old children spend time in centers, including child care centers and preschools. Her team began by exploring child-care center staff members’ perceptions of barriers to children’s physical activity. They conducted focus groups with 49 staff members from 34 child-care centers in the Cincinnati area (including Montessori, Head Start and centers in the inner city and suburban areas) as the first of several studies on this subject.
“We found several previously unreported barriers that meant kids had to stay inside, including inappropriate footwear such as flip flops and inappropriate clothing for the weather,” said Dr. Copeland. In some child care centers, if one child in the group shows up without a coat on a chilly day, she noted, that means the whole group has to stay inside. Even more surprising to the researchers was the fact that the child-care staff members said some parents appear to intentionally keep their children’s coats (or send children without coats) so they’d have to stay inside, which staff attributed to parents’ concerns about the child getting injured or dirty, or a having a cold that may be exacerbated by cold weather.
Teachers said they also felt pressure from some parents who were more concerned with children spending time on cognitive skills, such as reading and writing, than on the gross motor and socio-emotional skills (such as kicking a ball or negotiating with another child for a turn on the slide) that are best learned on the playground.
Then there was the mulch factor. “The staff members who participated in the groups were really concerned about mulch in the play area,” said Dr. Copeland. “Many said that the kids eat the mulch, or use it as weapons, or it gets caught in their shoes. It also requires constant upkeep. It’s certainly not something that we had anticipated as an issue, but judging by the amount of and intensity of the discussions among child care teachers, it really is.”
Dr. Copeland said the child-care center staff recognized that they themselves could sometimes serve as a barrier to children’s physical activity. “We heard reports of teachers talking or texting on cell phones instead of interacting with the children while on the playground,” said Dr. Copeland. She continued, “We found that a staff member who doesn’t like going outside-maybe she’s not a cold-weather person, or she thinks it’s too much work to bundle up and unbundle the children on a cold day - could act as a gatekeeper to the playground.” In some cases, staff reported that their own issues with being overweight prevented them from encouraging children’s physical activity.
“This initial qualitative research has identified a number of issues that we will be exploring in subsequent studies,” noted Dr. Copeland. “Clearly this is a complex issue -But finding out what the barriers are is the first step in addressing the problem and getting more kids involved in more much-needed physical activity.”
http://www.cincinnatichildrens.org/
Extra iron for infants who don’t need it might delay development
May 6, 2008
Child Health News
A new study suggests that extra iron for infants who don’t need it might delay development — results that fuel the debate over optimal iron supplement levels and could have huge implications for the baby formula and food industry.
“Our results for 25 years of research show problems with lack of iron. For us to find this result is a big deal, it’s really unexpected,” said Dr. Betsy Lozoff, University of Michigan research professor at the Center for Human Growth and Development, and the study’s principal investigator.
U.S. infant formulas typically come fortified with 12 mg/L of iron to prevent iron-deficiency anemia. Europe generally uses a lower amount. In infants, iron-deficiency anemia is associated with poorer development, and during pregnancy it contributes to anemia in mothers, contributing to premature birth, low birth weight and other complications.
“I thought that behavior and development would be better with the 12 mg formula,” said Lozoff, also professor of pediatrics in the U-M Department of Pediatrics and Communicable Diseases at the Medical School and C.S. Mott Children’s Hospital
The U-M study of 494 Chilean children showed that those who received iron fortified formula in infancy at the 12 mg used in the U.S. lagged behind those who received low-iron formula in cognitive and visual-motor development by age 10 years. Lozoff stressed that most children who received the 12 mg formula did not show lower scores. But the 5 percent of the sample with the highest hemoglobin levels at 6 months showed the poorest outcome. Your body needs iron to make hemoglobin, a substance in red blood cells that enables them to carry oxygen. High hemoglobin generally indicates sufficient iron.
Adversely affected children scored 11 points lower in IQ and 12 points lower in visual-motor integration, on average; the average overall score on both tests was 100. A similar pattern was observed for spatial memory and other visual-motor measures.
Lozoff noted that not many infants in Chile had high hemoglobin levels at the time since there was no iron-fortification program for infants and that more than 5 percent of U.S. infants might have high hemoglobin levels in early infancy.
In this randomized study, healthy infants without iron-deficiency anemia were given formula with either 12 mg or 2.3 mg iron from 6 to 12 months and followed to 10 years. The next step is to test the participants again at age 16, Lozoff said, who says that no such study has been conducted in the United States or elsewhere.
Iron deficiency occurs because babies grow so quickly they often “grow out” of the amount of iron they are born with. Breast milk is thought to contain the iron a baby needs for 4-6 months, Lozoff said. Other important sources of iron for infants include iron-fortified infant formulas and cereals, iron drops and meat.
Infants are typically not tested for hemoglobin or iron levels before 9-12 months. It would be premature to recommend earlier testing or to avoid supplemental iron based on the study’s results, Lozoff said. She expects parents to be concerned, but stressed that results must be reproduced in other studies.
“At this point there’s no basis for changing practice, but it’s really important that we have continued research on this issue,” she said.
http://www.umich.edu
Parental psychiatric disorders associated with autism spectrum disorders in the offspring
May 6, 2008
Child Health News
Parents of children with autism were roughly twice as likely to have been hospitalized for a mental disorder, such as schizophrenia, than parents of other children, according to an analysis of Swedish birth and hospital records by a University of North Carolina at Chapel Hill researcher and colleagues in the U.S. and Europe.
The study, “Parental psychiatric disorders associated with autism spectrum disorders in the offspring,” appears in the May 5, 2008, issue of the journal Pediatrics.
“We are trying to determine whether autism is more common among families with other psychiatric disorders. Establishing an association between autism and other psychiatric disorders might enable future investigators to better focus on genetic and environmental factors that might be shared among these disorders,” said study author Julie Daniels, Ph.D., an assistant professor in the UNC School of Public Health’s epidemiology and maternal and child health departments.
“Earlier studies have shown a higher rate of psychiatric disorders in families of autistic children than in the general population,” she said. “We wanted to see if the parents of autistic children were more likely to be diagnosed with mental disorders.
“Our research shows that mothers and fathers diagnosed with schizophrenia were about twice as likely to have a child diagnosed with autism. We also saw higher rates of depression and personality disorders among mothers, but not fathers,” Daniels said.
This information will help researchers look among related diseases, such as psychiatric disorders, for causes of autism, Daniels said. “It may eventually help identify opportunities to prevent or treat the disorder.”
The study examined 1,237 children born between 1977 and 2003 who were diagnosed with autism before age 10, and compared them with 30,925 control subjects matched for gender, year of birth and hospital. The large sample size enabled researchers to distinguish between psychiatric histories of mothers versus fathers in relation to autism. The association was present regardless of the timing of the parent’s diagnosis relative to the child’s diagnosis.
http://www.unc.edu/
Asthma attacks early in pregnancy put baby at greater risk of birth defects, new research suggests
May 6, 2008
Child Health News
Uncontrolled asthma during the first trimester of pregnancy greatly increases the risk of birth defects in babies, according to new research to be published in the June issue of the Journal of Allergy and Clinical Immunology.
Canadian researchers Lucie Blais, PhD, and Amelie Forget, MSc, concluded that women who had an asthma flare-up in the first three months of pregnancy were 48 percent more likely to have a baby with at least one congenital defect than asthmatic mothers who did not have a flare-up in the first trimester.
The rate of birth defects among the children of mothers who experienced a flare-up was 12.8 percent, versus a rate of 8.9 percent for mothers with better-controlled asthma, according to study data.
In total, researchers analyzed more than 4,300 pregnancies through health care and pharmacy records.
The findings underscore the need to keep asthma well-managed throughout pregnancy, but especially in the first trimester - a crucial period for fetal development.
The American Academy of Allergy, Asthma & Immunology (AAAAI) recommends all pregnant women with a history of asthma consult with an allergist/immunologist to ensure the asthma is well-controlled.
When a pregnant woman has trouble breathing, as during an asthma attack, both mother and fetus can experience a drop in the level of oxygen in their blood. A fetus needs a consistent supply of blood for normal growth and survival.
Pregnant women, like all asthma patients, should avoid common asthma triggers such as house dust mites, animal dander and smoke, according to the AAAAI.
An allergist/immunologist can prescribe safe and effective medications for controlling asthma during pregnancy.
To learn more about asthma and pregnancy or to find an allergist/immunologist in your area, visit www.aaaai.org.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI.
The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has nearly 6,500 members in the United States, Canada and 60 other countries.
http://www.aaaai.org
Nearly one-third of U.S. parents don’t know what to expect of infants
May 6, 2008
Child Health News
Almost one-third of U.S. parents have a surprisingly low-level knowledge of typical infant development and unrealistic expectations for their child’s physical, social and emotional growth, according to new research from the University of Rochester.
The findings, which suggest that such false parenting assumptions can not only impair parent-child interactions, but also rob kids of much-needed cognitive stimulation, will be presented Sunday, May 4, at the Pediatric Academic Society meeting in Honolulu, Hawaii.
“There are numerous parenting books telling people what to expect when they’re pregnant,” said Heather Paradis, M.D., a pediatric fellow at the University of Rochester Medical Center. “But once a baby is born, an astonishing number of parents are not only unsure of what to anticipate as their child develops, but are also uncertain of when, how or how much they are to help their babies reach various milestones, such as talking, grabbing, discerning right from wrong, or even potty-training.”
Moms and dads often misinterpret behaviors - some parents expect too much of babies too soon and grow frustrated; others underestimate their child’s abilities, preventing them from learning on their own.
Using data from the Early Childhood Longitudinal Study’s Birth Cohort (ECLS-B), Paradis and her colleagues analyzed the average parenting knowledge of a nationally-representative sample of parents of more than 10,000 9-month-old babies born in 2001. These parents first answered an 11-point survey designed to distinguish informed parents from less-informed parents (asking questions such as “Should a 1-year-old child be able to tell between right from wrong?” and “Should a 1-year-old child be ready to begin toilet-training?”). Those who scored 4 or fewer correct answers were considered to have low-level knowledge of typical infant development.
Paradis and colleagues then compared these knowledge scores to both scores from (1) a 73-point videotape analysis of the same families’ parent-child interactions while teaching a new task, and (2) from these parents’ self-reports of how often they engaged their child in enrichment activities (e.g. reading books, telling stories, or singing songs).
The analysis revealed that 31.2 percent of parents of infants had low-level knowledge of infant development, and that this low-level knowledge correlated with lower parental education level and income. Still, even when controlling for maternal age, education, income and mental state (e.g., depression), low-level knowledge of infant development still significantly and independently predicted parents being both less likely to enjoy healthy interactions with their infants during learning tasks and less likely to engage their children in regular enrichment activities.
“This is a wake-up call for pediatricians,” Paradis said. “At office visits, we have a prime opportunity to intervene and help realign parents’ expectations for their infants, and in turn, promote healthy physical, social, and emotional development for these children. On the other hand, we still have more work cut out for us - additional research is needed to explore how these unrealistic expectations form in the first place.”
http://www.urmc.rochester.edu
Children affected by parents’ behavior following trauma
May 6, 2008
Child Health News
A new study in the Journal of Marital and Family Therapy examines the role that specific parenting practices may play in children’s adjustment after trauma.
The study suggests that the quality of parenting practices following trauma can mediate the relationship between trauma exposure and child adjustment. The study finds that certain parenting behaviors have the potential to significantly improve children’s outcomes.
Effective parenting practices provide a protective environment surrounding children and the authors have proposed a framework that draws>http://www.blackwellpublishing.com/
Children’s experiences in a pediatric intensive care unit
May 6, 2008
Child Health News
Nearly one in three children admitted to pediatric intensive care will experience delusions or hallucinations, which put them at higher risk for post-traumatic stress symptoms, according to a new study of children’s experiences in a pediatric intensive care unit (PICU).
The study, which appears in the first issue for May of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society, is believed to be the largest ever conducted on children’s memories of PICU.
The results confirmed the clinical experience of the study’s first author, Gillian Colville, B.Sc., M.Phil., a clinical psychologist, and underscore the need to look at this issue more closely. “I have worked for 16 years in pediatric intensive care and have seen a considerable number of children in distress, but have found that there is very little in the literature about children’s experiences,” said Ms. Colville.
To determine whether she was witnessing a unique population of children, or if hallucinations and delusional memories were an overlooked but common experience for children in the PICU, Ms. Colville and her collaborators recruited children over the age of seven who were discharged from the 21-bed PICU at Great Ormond Street Children’s Hospital in London, over the course of 18 months. Each child’s medical condition and treatment was noted and they were given a psychological interview three months after discharge to screen them for post-traumatic stress symptoms in relation to their memories.
Of the 102 children who completed interviews, two in three recalled something factual about their stay at the PICU- and half of these had only fragmentary, single memories, mostly images of family members. But one in three children reported delusional memories of their stay in PICU, including hallucinations. It was these children who reported delusional memories that had a significantly higher score on the post-traumatic stress screening test than others.
“These findings are interesting because it has been assumed that the actual experiences in the PICU would be more likely to lead to post-traumatic stress symptoms following discharge,” said Ms. Colville. “However, our results indicate that post-traumatic stress symptoms are associated with delusional memories rather than factual ones. The hallucinations children reported were overwhelmingly disturbing and frightening, similar to those reported by adult intensive care patients and heroin addicts going through withdrawal.”
The findings have important clinical implications, as the timing of the hallucinations appeared to coincide with the period during which they were being weaned off the sedatives commonly prescribed on PICU (benzodiazepines and opiates) and children were five times as likely to report having had delusions or hallucinations if they had been prescribed opiates and benzodiazepines for more than two days.
The authors do not suggest that the drugs be discontinued, but that they do warrant further study. Additional research could establish whether alternative types of sedation or the introduction of drug holidays might produce fewer traumatic delusional memories. The authors also suggest altering the physical environment and providing psychological orientation cues for children in the PICU, such as demarcating day and night, to help reduce these symptoms.
“But above all, medical professionals and families should be made aware of the possibility that children may have these disturbing hallucinatory experiences, and greater efforts should be made to monitor their psychological adjustment after PICU,” said Ms. Colville.
http://www.thoracic.org/
