"Pediatric News Updates" are reported from actual news sources, but do not necessarily reflect the opinions of Families United on the Net, www.thefunplace.com. For the well-being of all children, parents should not try to diagnose their children, but should seek the advice and care of a pediatrician or family physician.



TRADITIONAL GUIDELINES FOR DISCHARGING HIGH-RISK NEWBORNS INADEQUATE
August 1998 - Hospital discharge of high-risk newborns has traditionally been based on a preset weight, usually 5 or 5 1/2 pounds. However, a new policy statement from the American Academy of Pediatrics (AAP) says single set of criteria for discharging these newborns from the hospital is inadequate. The new AAP statement appears in the August issue of Pediatrics. With advances in neonatal intensive care and changes in economic and societal issues, the AAP emphasizes the importance of individualized planning and physician judgment when determining discharge. The policy statement identifies four categories of high-risk infants:

1. The pre-term infant
2. The infant who requires technological support
3. The infant at risk because of family issues
4. The infant whose irreversible condition may result in an early death.

These discharge decisions require balancing infant safety and well being with family needs and capabilities, while also considering available and adequate community resources and support services.


YOUNG CHRONIC FATIGUE SYNDROME PATIENTS DIFFER FROM ADULT SUFFERERS
August 1998 - The outcome is brighter for children and adolescents suffering from chronic fatigue syndrome than for adults with the same diagnosis according to researchers from the New York University School of Medicine and the Albert Einstein College of Medicine. These researchers reviewed charts of 58 children and adolescents previously enrolled in a New York hospital chronic fatigue treatment program and conducted follow-up interviews with their families. They found that 95 percent of these former patients were considered by their families as either "cured" or "improved" one to four years after beginning treatment - a prognosis better than that reported in adult studies. Researchers found that at the time of follow-up, 71 percent of the families interviewed indicated that the medical care they had received for their children had been helpful, and 68 percent felt that psychosocial care had been beneficial. For this reason, the study's authors conclude that despite earlier cited reservations in the medical community against diagnosing chronic fatigue syndrome in pediatric patients, diagnosis of chronic fatigue syndrome in this age group can have a positive effect on recovery.


SWALLOWING CHEWING GUM CAN BE HAZARDOUS TO CHILDREN'S HEALTH
August 1998 - Swallowing chewing gum can cause numerous health problems and it should not be given to young children who cannot understand this point, according to pediatricians from Nemours Children's Clinic, Orlando Fla., who compiled case studies to illustrate the potential health hazards of chewing gum for small children. According to the study's authors, swallowing gum can cause many adverse health effects, including diarrhea, abdominal pain, flatulence, mouth ulcers, and dental and jaw problems, and is not recommended for young children. In addition, it can block the esophagus and colon. The first case study highlighted in the study is that of a 4-year-old boy with a two-year history of constipation. After numerous tests and different treatments, doctors discovered that his fecal matter largely consisted of chewing gum. On further investigation they learned that the boy always swallowed his gum, after chewing up to seven pieces each day. In another case, a 4-year-old girl suffered from complications from constipation. Again tests and treatment failed until doctors removed a fecal mass of chewing gum. The child had the habit of swallowing gum, often just to get another piece. The third case concerned a 1-year-old girl who drooled, coughed and had trouble swallowing. Doctors discovered four coins encased in chewing gum lodged in her esophagus. The study's authors note that children who show signs of chronic constipation or acute coughing and drooling should be examined to determine whether chewing gum has been swallowed.


TEEN GAMBLING EPIDEMIC LINKED TO RISKY BEHAVIOR
August 1998 - Between 76 percent and 91 percent of all teens will have gambled by the time they are seniors in high school. Researchers from Children's Hospital, Harvard Medical School, Boston, discovered that adolescents who gambled reported participating in an increased number of at-risk behaviors in other areas of their lives. The study's authors reviewed a survey of nearly 17,000 eighth through twelfth grade students. Of this group, 53 percent reported gambling in the last 12 months and 7 percent reported that gambling caused problems with their families and friends. Overall, illegal drug use was nearly doubled by teens who had gambled in the past year (15percent) vs. teens who had not (8 percent), and that number was nearly doubled again (28 percent) by students who reported having problems related to gambling. In addition, gambling teens were approximately twice as likely as non-gambling teens to have been in a fight or to have carried a weapon in the last 30 days. Each risky behavior that a student reported participating in made them more likely to have gambled and to have experienced problems in relationships because of it. According to the authors this study confirms gambling to be common among youth. Because research has shown most adult pathologic gamblers start gambling in adolescence and develop their addiction over 10 or more years, the researcher stress the need for early intervention programs for teens who gamble -- which may be beneficial in preventing this addiction. In conclusion, the study's authors suggest that such intervention programs could also identify youth at risk of participating in other risky behaviors, and allow prevention mechanisms to be implemented.


SCHOOLS HELP CHILDREN REDUCE CARDIOVASCULAR DISEASE RISK FACTORS
August 1998 - Children who participate in cardiovascular health education programs in schools may see a decrease in risk factors such as cholesterol and body fat, according to researchers from the University of North Carolina at Chapel Hill University of California, San Francisco, and Emory University, Atlanta, who studied 422 third and fourth graders with at least two risk factors for cardiovascular disease; low aerobic power and either high cholesterol or control. Regular teachers taught children enrolled in the classroom-based intervention group twice a week about healthy foods, the importance of regular exercise and the dangers of smoking. In addition, they participated in physical activities such as jumping rope, relays, parachute games or aerobic dance three times a week. Two types of intervention were used for those assigned to the risk-based group depending on their risk factors: physical activity classes for those with low aerobic capacity and nutrition classes for those with high cholesterol or obesity. Children in the control group continued their usual health and physical education classes. Researcher compared the three groups to determine differences in cholesterol, blood pressure, body mass index, body fat, eating and activity habits, and health knowledge. Children in both intervention groups experienced similar changes but were significant differences when the intervention groups were compared to the control group. In addition to drops in cholesterol, blood pressure and body fat in the intervention groups, there was an increase in health knowledge. Researchers conclude that school intervention, especially the case of classroom based intervention, is effective for preventing future cardiovascular disease.


MANY CAREGIVERS CAN'T PROVIDE MEDICAL INFORMATION ABOUT THEIR SPECIAL NEEDS CHILDREN
August 1998 - Many parents, family members and guardians are unable to supply vital information about the medical condition of the special needs child in their care in emergency situations, according to researchers at the University of Maryland in Baltimore and Our Lady of Lourdes Medical Center in Camden, N.J., who studied 49 pairs of children and caregivers seeking health care for chronic medical problems. In 85 percent of the cases, the caregiver was the child's parent. Responses to questions revealed that more than half of the caregivers could not provide their child's specific diagnosis and 29 percent could not provide an accurate list of the medications their child was taking. Only 25 percent of the caregivers could name their child's sub-specialist and phone number of the sub-specialty clinic where their child was normally seen. None of the children in the study wore medical identification jewelry. The researchers recommend the use of form developed by the American College of Emergency Physicians with the AAP, which includes the important medical data, needed to assure proper treatment of children with special health care needs. The authors also recommend identification jewelry as a mechanism for conveying needed information. The study authors note that while some caregivers are able to supply the information that any health care provider would need to treat their child, "they cannot guarantee that they will be immediately available to provide essential information on their child in every emergency situation."

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