Healthy isn?t something you are or aren?t. It?s a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It?s a balance between living well and taking care, and you can start right where you are.
A blog by Christina Elston
Healthy isn't something you are or aren't. It's a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It's a balance between living well and taking care, and you can start right where you are.


Archive for December, 2010

In the Air: In Utero

Thursday, December 30th, 2010

Before They Are Even Breathing, Air Pollution Can Hurt Babies’ Health

Victoria Niklas, M.D., takes care of some of the area’s sickest newborns at the NICCU at Childrens Hospital Los Angeles. Grace was born early because her mother had preeclampsia.

Victoria Niklas, M.D., takes care of some of the area’s sickest newborns at the NICCU at Childrens Hospital Los Angeles. Grace was born early because her mother had preeclampsia.

 

It was back in the late 1980s, as an OB-GYN in South Los Angeles, that Robin Johnson, M.D., says she first understood how important a mother’s breathing can be to her unborn baby. One of her patients had asthma so bad it landed her in the hospital three to four times a month.

“She eventually delivered, and delivered early,” Johnson says, though the baby was almost at term. What surprised the doctor was that, though the mother was of normal stature and not really sickly, “she ended up having this little four-pound baby.”

Today, Johnson teaches at USC’s Keck School of Medicine and is a fellow with the Reach the Decision Makers Training Program, created by the National Center of Excellence in Women’s Health at UC San Francisco. Her project: To convince the U.S. Environmental Protection Agency (EPA) to look at birth outcomes when setting environmental policy. The agency says they do consider birth outcomes in the “science assessment phase” of National Ambient Air Quality Standard reviews, but confirms that birth outcomes aren’t taken into account when analyzing costs and benefits of setting a new National Ambient Air Quality Standard. 

“Women and children are always the last variable that is thought about,” Johnson says. “It’s up to us to say, Hey, wait a minute, we’re where it starts! When you talk about the chicken and the egg, we’re both.”

Around 150,000 babies are born in L.A. County every year, and when they are born to mothers breathing polluted air they are up to 30% more likely to be premature or underweight, studies over the past decade show. Research out last month from a team at USC, UC Davis and Childrens Hospital L.A. also found they could have double the risk of autism. Click to read more about air pollution in utero …

Small Study Links BPA to Reduced Egg Quality In Women

Wednesday, December 29th, 2010

water-bottleThe first evidence that exposure to bisphenol A (BPA) might compromise the quality of a woman’s eggs is in. A small study from UC San Francisco found women who had double the level of BPA in their blood had half as many eggs that would fertilize, compared with women who had lower BPA levels. The 26 women in the study, published this month in the journal Fertility and Sterility, were having their eggs retrieved for in vitro fertilization (IVF).

BPA exposure is common, as the chemical is used in a number of plastics, and in the linings of many food and beverage cans. When the Centers for Disease Control and Prevention (CDC) conducted an analysis of the U.S. population in 2004, they found BPA in the urine of nearly everyone they tested.

More studies need to be done to confirm the link. But this widespread exposure makes any impact of BPA on reproduction significant, which makes those studies worth doing.

Meanwhile, there are ways to reduce your exposure. Avoiding plastics #3 (PVC), #6 (styrene, in Styrofoam) and #7 (polycarbonate) is a good start. And you can avoid heating or storing food in plastic containers, and toss that vinyl shower curtain.

The UCSF Program on Reproductive Health and the Environment has tons more tips. Check them out here …

Health-E Stuff: Learn With Yoga

Tuesday, December 28th, 2010

learn-with-yoga-abc-yoga-cards-for-kids1Who couldn’t use a little calm and focus after the hectic pace of the holidays? Here’s a way to carve out a little quiet time, and then take advantage of your child’s Zen-like state for some skill building.

Learn With Yoga: ABC Yoga Cards for Kids ($19.99, www.learnwithyoga.com) is a deck created by a speech pathologist, with 26 poses the kids can try, plus 26 bonus cards with learning ideas for you. So while your child is posed as an “archer” or “happy baby,” you can chime in with questions like “What letter does ‘archer’ begin with?” or “What feeling is the opposite of happy?”

The 5-by7-inch pose cards feature bright, appealing illustrations, explain the benefits of each pose (i.e. “archer” increases balance and strengthens the legs and arms) and give a detailed, step-by-step explanation of how to get into the pose. The cards on their own would be enough for even a yoga beginner, and the poses are basic enough that there’s little danger of injury even if they’re not done correctly. If you’ve had a beginning yoga class or two, they would be even easier to use.

The instructor cards offer up the pose instructions, plus suggestions for questions and activities that build reading readiness, spatial concepts and other skills – from preschool through age 8-10.

The cards are also color coded according to the type of skill the pose supports (grounding, creativity, self-esteem, teamwork, communication and reasoning) and grouped for warm-up, basic, intermediate and resting uses. This makes it easy to group the cards into a logical sequence and put together a mini-yoga session. Bonus: Get into the poses along with your child, and soak up some yoga for yourself.

Looking For a Trainer?

Monday, December 27th, 2010

trainerAs we head into the new year, maybe you’d like some help with your get-fit or get-slim goals. One way to boost both your resolve and your results is to hire a trainer. Alexis Peraino, M.D., who has a degree in exercise physiology and selects the personal trainers referred by the Cedars-Sinai Center for Weight Loss in Los Angeles, offers her tips for finding one who can get you there. She says to ask about:

Credentials: The most respected come from the American College of Sports Medicine, the National Academy of Sports Medicine and the American Council on Exercise.

References: Follow through and speak with past clients.

Scheduling: Is she available when you need her? What’s her cancellation policy?

Your profile: A good trainer should be interested in your current fitness level, plus medical conditions, medications, previous injuries and surgeries.

The Training Arc: Warm up, cool down, cardio, resistance and exercises to build flexibility should all be part of your program.

Homework: Ideally, you’ll work out more often than your trainer’s schedule allows, so find someone who can suggests workouts you can do on your own – exercises that will eventually become healthy habits.

Variety: If your trainer can bring in activities from a variety of discliplines, such as weight training, yoga, or martial arts, you’re less likely to get bored.

Diet: Proper diet and exercise should go hand in hand. A trainer who can give sound nutrition advice is a gem, but beware those determined to sell you supplements, protein drinks or fat burners.

Also keep in mind that your relationship with your trainer should last long enough for you to change your habits, but doesn’t need to continue forever. Think you can’t afford the investment? Consider finding a friend with similar goals and splitting the cost of semi-private sessions.

Get referrals from the American Council on Exercise here … 

 

Just Ask: A Cold From Nasal Flu Vaccine?

Thursday, December 23rd, 2010

Beth Writes:

My 12-year-old daughter had the nasal flu vaccine a few weeks ago. A week later she developed a bad nose cold (no fever) and is still not fully recovered. I’m not sure if it’s related, but wanted to ask if this is possible. Most importantly, I want to know if there are any known long-term consequences of having the nasal vaccine. I’m hoping we made the right decision to have the nasal vaccine instead of the injection.

Health-E Responds:

nasal-fluI took your question to James Cherry, M.D., a professor of pediatric infectious diseases who works with Mattel Children’s Hospital at UCLA. Asked if your daughter’s cold could have been related to the nasal flu vaccine, he responded, “Almost certainly not.” Some people do experience symptoms after having the nasal flu vaccine, but Cherry says these come on right away. Since your daughter’s cold didn’t come along until a week after she received the vaccine, “Unfortunately, she was exposed to somebody with a cold and she caught it,” Cherry says.

No long-term side-effects have been documented from the nasal flu vaccine. Cherry does point out that young children seem get a slightly better immune boost from the nasal vaccine, while adults do better with the injection. Your daughter being right in the middle, both should be fine.

He also says the flu vaccine, in either form, is well worth getting. “You have roughly 35,000 deaths a year from flu, and a large number of those are preventable through the vaccine.”

Jill Hoffman, M.D., acting head of the Division of Infectious Diseases at Children’s Hospital Los Angeles also chimed in with this response:

I cannot answer this question specifically as it relates to your child, but I can tell you from my experience and expertise that the most common side effects are stuffy nose and mild scratchy throat occurring up to a few days after receipt of the FluMist nasal vaccine. Since cold viruses are very common, especially this time of year, it is possible that your daughter was coincidentally incubating a cold virus at the time of the vaccine, which then manifested itself a week later. The vaccine is very safe when given to normal children and adults (2-50 years old) and no long-term side effects have been documented, except for protection from influenza for a year! You cannot get influenza from the vaccine.

The vaccine is NOT recommended for :

  • People less than 2 years of age
  • People 50 years of age and over
  • People with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system.
  • Children <5 years old with a history of recurrent wheezing
  • Children or adolescents receiving aspirin
  • People with a history of Guillain–Barré Syndrome that occurred after receiving influenza vaccine
  • Pregnant women
  • People who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.

If you have further questions about your daughter, I would discuss these with your pediatrician and consult the Centers for Disease Control website (www.CDC.gov). 

Got a question about your family’s health? Click here, and we’ll find an expert to answer it!

Storm Watch: Stock Up

Wednesday, December 22nd, 2010

So maybe we’re not that used to storms in Southern California. Even so, the one that’s pounding its way through this week is a doozy. And it’s a nice occasion for a friendly reminder about the types of supplies we should all have on hand – just in case.

umbrellaNo matter where you live, it’s a good idea to prepare for “nature” at its most exciting. Here are 10 items the Los Angeles County Office of Emergency Management says we should all have on hand.

  1. Water
  2. Food
  3. Cash
  4. Clothes
  5. Flashlight
  6. First Aid Kit
  7.  Medications
  8. Radio
  9. Toiletries
  10. Tools

They recommend that families also put together a communications play, including a place to meet in case of disaster, and out-of-state contacts in case family members are separated and unable to get in touch.

 

If you are cleaning up a home that has been damaged by flash flooding or mud:

  • Do not swim in, bathe in, or use flood water for cooking or drinking, because of the possibility the water contains chemicals or bacteria.
  • Report sewer line breaks to the department of public works at 800-675-HELP.
  • Wear sturdy shoes and gloves while cleaning.
  • Discard drink containers that have been covered in mud, even if they are sealed.
  • Discard food that has been covered in mud unless it was stored in an airtight container.

For information on disaster readiness, visit www.publichealth.lacounty.gov.

 

Safety Commission Bans Sale of Drop-Side Cribs

Tuesday, December 21st, 2010

The U.S. Consumer Product Safety Commission (CPSC) voted last week to ban the manufacture, sale and re-sale of drop-side cribs, which have sides that slide up and down. More than 30 babies have been killed during the past decade, when the drop-sides of their cribs partially detached, allowing the children to become trapped and strangle. As of June, all cribs manufactured and sold must have fixed sides.

Health-e Stuff: A Box For New Moms

Monday, December 20th, 2010

Babies don’t come with instruction manuals, but now you can get a hand accessory kit to help smooth some of the bumps of those early days. The Newborn Kit ($39.95, www.momsmedicinechest.commoms-medicine-chest-newborn-kit-front-300ppi) from Mom’s Medicine Chest packages a baby thermometer, infant Tylenol, saline drops, and other essentials for coping with everything from fever to Baby’s first cold, colic to diaper rash.

These are packed into a sturdy 7-by-9-inch clear plastic case, so you can see your supplies. And there’s extra space for other things you might need to store, like a spare pacifier or baby lotion.

As a bonus, the kit includes a handy information booklet, written by the pharmacist mom who developed Mom’s Medicine Chest. It explains how and when to use the medicines included in the kit and how to safely take Baby’s temperature. Additional kits are available for newborn travel, and for when you’re ready to send your baby off to college.

Could Mom’s Depression Impact Baby’s Development?

Wednesday, December 15th, 2010

cryingbabyIf you are pregnant and have symptoms of depression, seek out a therapist. That’s the take-home message from a new study that found higher levels of stress hormones in babies born to depressed moms. As many as one in every five women experiences depression during pregnancy.

Experts say it is difficult to tell whether the differences noted in the study – which included decreased muscle tone and quicker adjustment to stimuli like light and sound in babies born to depressed moms – are good or bad, or what the long-term impact might be. Still to be answered: Just how much might hormone activity in the uterus alter infant brain circuitry, and could it predispose the baby to later behavioral and psychological disorders?

The study involved 154 pregnant women with low, intermediate or high levels of depression. The research was conducted by University of Michigan Health System researchers and published online Dec. 9 in Infant Behavior and Development.

Research continues. Meanwhile, experts also note that steps taken to help foster mother-child bonding after birth can help counteract the effects of a mother’s depression during pregnancy, and help stimulate baby’s brain development.

Learn more … 

 

New Food Allergy Guidelines Stress Need For Thorough Testing

Monday, December 13th, 2010

food-allergyIs your child one of the millions (approximately 3 million in the U.S., the CDC said in 2008) diagnosed with food allergies? New government guidelines suggest you should pay attention to how that diagnosis was made.

Among other things, the guidelines, released Dec. 6 by the National Institute of Allergy and Infectious Diseases and a panel of experts, stress that doctors should not rely on any single test to determine whether or not someone is allergic to a particular food. And this means you probably shouldn’t rely on your pediatrician to confirm a food allergy, says Stanley Fineman, M.D., president-elect of the American College of Allergy, Asthma and Immunology. Only an allergist is likely to test thoroughly enough for a good diagnosis.

This guidance suggests that the burgeoning number of food-allergy cases – which nearly tripled among kids between 1997 and 2006, according to government research – has been accompanied by at least some misdiagnosis, probably because doctors rely too much on blood tests or skin-prick tests alone. Fineman, who was not involved in writing the guidelines, says that anyone identified as having food allergies based on “one blood test in one office one time” might benefit from letting an allergist take a closer look.

Tools an allergist might employ include taking a health history, performing a full medical evaluation, a blood test, and a skin scratch test. In some cases, these are supplemented by what Fineman calls a “cautious oral challenge,” where a child eats a very small amount of the food in question in an allergist’s office, where the doctor is equipped to deal with allergic reactions. (Don’t try this at home!)

A recheck might even be in order for children with a solidly diagnosed food allergy, because many outgrow their allergies over time.

Giving allergy-free kids the all-clear to eat a regular diet is important for good nutrition, Fineman says. He’s concerned about children who visit him “and they’ve had one blood test and been told they’re allergic to half a dozen different foods and they’re on a restricted diet.” Frequently taboo are milk and eggs. “Those are two good sources of protein that children often rely on,” he explains. “You don’t want to restrict those foods without a good diagnosis.”

These initial guidelines are meant to help healthcare providers. A “translation” for the general public is due out in early 2011.

Other points stressed in the guidelines:

• Scientific evidence doesn’t support use of blood test called the IgG assay, which looks for a type of antibody thought to suggest a subtle type of food allergy, to make allergy diagnoses.

• Oral food challenges (the gold standard) aren’t used often enough to confirm suspected cases of food allergy.

• People of all ages with known food allergy should have ready access to self-injectable epinephrine in case of severe allergic reaction.

• Immunotherapy treatments – where someone is exposed to small amounts of an allergen over time to build tolerance – hasn’t yet proven safe and effective in treating food allergies.

And if you’re pregnant or breastfeeding and trying to keep your child from developing food allergies by monitoring your own diet, the jury is still out. The panel that developed the guidelines says there isn’t enough evidence yet to say that avoiding or eating certain foods will increase or decrease your child’s risk.

Check out a National Institute of Allergy and Infectious Diseases “What’s In It For Patients” guide to the guidelines … 

Visit the American College of Allergy, Asthma & Immunology and check out their “Ask the Allergist” feature …