Daily Dose of DrGreene

Omega 3’s, Colostrum, and Allergies

As I describe in my book, From First Kicks to First Steps what mothers eat while they are pregnant influences the health and development of their babies in many ways. Each meal can be a gift to your baby even before you get to see each other. Among other things, some food choices can influence the odds that your baby will later develop allergies. New research suggests that the balance between omega- 3 fatty acids (such as DHA) and omega-6 fatty acids (such as linoleic acid) can also tilt these odds. Researchers at the Leipzig Allergy Risk Children’s Study Group analyzed the fats in the colostrum from mothers of children at high risk for allergies. The results were published in the April 2004 Allergy. Those with relatively high levels of omega-6 fatty acids were the most likely to develop cow’s milk allergies. Those with the lowest levels of omega-3 fatty acids were most likely to develop allergies overall. Both omega-3 and omega-6 fatty acids are essential in the diet – but in balance. Unfortunately, many Western diets tend to be too heavy on omega-6’s at the expense of omega-3’s. Key omega-3 fatty acids (such as DHA) are found in oily cold water fish such as tuna and wild salmon. But eating fish must be balanced against the risks of toxins like mercury and PCBs. (Here is one smart seafood calculator) Supplements are another good option. And other omega-3 fatty acids can be found in dark green leafy vegetables, walnuts, flaxseeds, and some canola oil.

Alan Greene MD FAAP

Zinc for Pneumonia

What we eat affects our health. Zinc is an essential nutrient that has many functions in the body, including being critical for optimal operation of the immune system. We know that getting enough zinc can be useful for preventing and treating diarrhea. We know that it can be effective for preventing respiratory infections, including pneumonia. Might zinc supplements be useful as a extra medicine when treating kids with pneumonia? Researchers at Johns Hopkins University and the Centre for Health and Population research studied 270 young children from Bangladesh with severe pneumonia. Half received antibiotics and 20 mg of zinc; the other half received antibiotics and a counterfeit that looked like zinc. The results were published in the May 22, 2004 Lancet. Those treated with zinc did much better, with more rapid improvement of severe symptoms, and hospital stays that averaged a full day shorter. More work needs to be done on this, but I suspect the benefit is more profound in kids who are zinc deficient. Putting this in perspective, the USDA's "What We Eat in America" survey reported that over 62% of young children here do not get enough zinc in their diets.

Alan Greene MD FAAP

Lingering Benefits of Nursing

Parents often hear about the powerful short-term benefits of breastfeeding. But the good news doesn't stop when your baby is weaned. We're learning more all the time about the enduring gift you give each time you nurse. When you're up at night tenderly feeding your baby, you're also silently taking care of your teenager in the future. Sometimes it's hard to engage teens in healthy behavior, but when baby's who nurse have grown to be adolescents, they are likely to have a 14 percent lower cholesterol than their peers -- which translates into about a 14 percent reduction in the risk of heart disease. Infant nutrition appears to permanently alter the lipid profile later in life, and the risk of developing atherosclerosis, and therefore cardiovascular disease in general. The study that uncovered this benefit was performed at the Institute of Child Health in London and published in the May 15, 2004 Lancet. This study is welcome news at a time when overall teen obesity, elevated cholesterol, and heart disease are more common than ever before. What kids eat when they are babies can benefit them for years to come.

Alan Greene MD FAAP

Getting Un-Allergic to Antibiotics

The rise of bacterial resistance isn’t the only force limiting antibiotic choices. Allergies to antibiotics have risen over the years as antibiotic use in children (and in animal agriculture) has become more common. Both of these problems can be decreased by saving antibiotics for situations where they are really needed. Even so, sometimes children become allergic to the only antibiotics that work well for their situation. Often, side effect rashes are confused with allergies, but true allergies are also real problems. Thankfully, antibiotic desensitization treatment shows promise for reversing these allergies. When I was a child, I had successful allergy shots to desensitize me to grass allergies. Researchers at Children’s Hospital Boston, led by Dr. Stuart Turvey, reviewed their 5-year experience with antibiotic desensitization. The results were published in the April 2004 Annals of Allergy, Asthma, and Immunology. A total of 57 different desensitization treatments were performed; 43 of them were successful in making those antibiotics available to the children again. For some kids, this could be a real lifesaver!

Alan Greene MD FAAP

Dental X-Rays

A lead apron to protect the reproductive organs may not be enough to protect a developing baby when her mother has dental x-rays. Researchers at the University of Washington analyzed the pregnancies of 5,585 women and found that that those who had received dental x-rays were more than 3 times more likely to deliver a low birth weight baby at term. The full results of the study were published in the April 28, 2004 Journal of the American Medical Association. Current guidelines on x-rays during pregnancy are based on the idea that only direct radiation to the reproductive organs is a problem. This study suggests that even very-low-dose radiation to a mother's head and neck can stunt her baby's growth, perhaps by affecting her thyroid gland. We know that a pregnant mother's thyroid hormone is important for her baby's physical and mental growth. Overall, about 1 in 10 women in the U.S. get dental x-rays while pregnant. While clean teeth and gums are important during pregnancy, I don't recommend any unnecessary x-rays while pregnant, even very-low-dose x-rays of the mouth.

Alan Greene MD FAAP

Breastfeeding and Saving Lives

Many studies have demonstrated a variety of benefits from breastfeeding, including lowering the risk of sudden infant death syndrome (SIDS). The first study linking breastfeeding with overall lower infant mortality was presented at the Pediatric Academic Society meeting in San Francisco on May 2, 2004 (Dr. Benjamin’s Spock’s birthday). Most babies do well however they are fed. But, an analysis of 8944 U.S. babies demonstrated that those who were breastfed had a 21 percent lower chance of dying for any reason during the first year. Detailed results of the study appear online in the May, 2004 Pediatrics. The longer children were breastfed, the greater the effect. In the study, the risk of death from SIDS was reduced by 16 percent in breastfed babies; the risk of death from injury by 31 percent. The good news is that among non-breastfed babies in the U.S., age one month to one year, about 997.3 out of 1000 will survive. Among those who are breastfed, about 997.9 will survive. The 0.6 per 1000 difference seems small, but with about 4 million babies born each year, this difference would be about 2,400 babies’ lives in the U.S. alone. Around the world, 132 to 135 million babies are born each year – 97 out of 100 babies are not born in the U.S. On May 3, 2004 the estimated U.S. population is over 293 million. But the world population is 6.4 billion. More than 19 out of twenty people in the world do not live in the U.S. Encouraging breastfeeding is an important part of improving children’s health around the world.

Alan Greene MD FAAP