Only one of the 29 infants who received human milk developed the dangerous intestinal condition necrotizing enterocolitis (NEC) and recovered without surgery, compared with five out of the 24 babies on formula, four of whom required surgery. The findings, say the researchers at Johns Hopkins Chidren’s Center, justify a move toward a “human milk only” diet in extremely premature babies — those born weighing less than 1,500 grams, or 3.3 pounds.

“The stark differences in the risk of NEC, its complications and the need for surgery between babies who receive human donor milk and those who get formula signal the need for a change in feeding practices across neonatal intensive care units,” said lead investigator Dr. Elizabeth Cristofalo, a neonatologist at Hopkins Children’s, in a press release.

Moreover, babies who got human milk tolerated feeding better, allowing them to be taken off supplemental IV nutrition much sooner — after 27 days on average — than the group who received cow’s milk formula.

Those babies spent an average of 36 days on IV nutrition, largely because their intestinal tracts were not adapting to food as well, the researchers say. IV nutrition, used temporarily in all premature babies to supplement feeding, carries risks, the most serious of which is liver damage.

“Although we didn’t look specifically at liver function, we know from experience and from previous research that prolonged IV nutrition can harm a premature baby’s liver,” Cristofalo said. “Using human milk cuts that risk by allowing us to wean babies off IV nutrition sooner.”

Necrotizing enterocolitis is marked by tissue damage to the baby’s bowel. Because up to 40 percent of babies who develop NEC die, the condition is considered an emergency. Some cases of NEC can be treated with antibiotics and by temporarily withholding of food, but some babies require surgery to remove the dead portions of the intestines. The remaining intestine, however, can develop scarring that leads to poor absorption of nutrients, growth problems and the need for more surgery down the road.

The health advantages of mother’s milk have been well established, but some concerns about donor milk have lingered, including how it compares to mother’s milk and whether it is, indeed, superior to cow milk formula. The new findings should resolve any residual doubts about the risks and clarify the benefits of human donor milk, the investigators said.

The multi-center study is the first trial of its kind to compare the risk for NEC and NEC surgery between premature infants fed human donor milk and those fed preterm baby formula. An earlier study by the same team showed that babies who get their own mother’s milk fortified with the standard cow milk protein are more prone to NEC than babies given a combination of their mothers’ milk fortified with human donor milk.

Other hospitals participating in the study included Cohen Children’s Medical Center of New York, University of Texas, University of Florida-Gainesville, Innsbruck Medical University in Austria, Baylor College of Medicine and Children’s Hospital and Research Center, Oakland, Ca.

For more on child medical issues, see the library of articles by Daytona Beach child injury attorney.

These findings raise safety concerns, note the researchers. They point out the paucity of evidence supporting the efficacy of these medications to treat young children, their known adverse metabolic effects, and unknown long-term effects on the developing brain.

The rate of antipsychotic drug treatment among privately insured children, aged 2-5 years, rose from 0.78 to 1.59 per 1,000 children during the study period, and increased more for girls (148 percent) than for boys (94 percent).

Treatment with antipsychotic drugs rose significantly for children diagnosed with pervasive developmental delay/mental retardation (57 percent), disruptive behavior disorders (54 percent), and attention deficit/hyperactivity disorder (70 percent).

Antipsychotic drug treatment for children without a diagnosed mental disorder increased by 65 percent, although the rate per 1,000 children remained low. Over the same time period, the rate of nondrug interventions decreased or remained unchanged. The rate of mental health assessments for children treated with antipsychotic drugs remained essentially unchanged from 1999-2001 (40 percent) to 2007 (almost 41 percent).

While 50 percent of children treated with antipsychotic drugs in 1999-2001 had at least one psychotherapy session during a treatment year, this rate fell to slightly more than 41 percent by 2007.

These findings were based on analysis of service and pharmacy claims from the MarketScan Research Databases on privately insured individuals and their families from 150 United States employers. The study was funded in part by the Agency for Healthcare Research and Quality (AHRQ) to the Center for Education and Research on Mental Health Therapeutics at Rutgers University.

Despite increasing rates of antipsychotic use by very young children, provision of formal mental health services remains sparse, the authors note. These service patterns highlight a critical need to improve the availability of specialized and well integrated mental health care for very young children with serious mental health problems.

For more on child heath issues, see the library of articles by Daytona Beach child injury lawyer.

If you give birth in America, chances are good your doctor will use a fetal monitoring device during delivery. In fact, doctors use fetal monitoring devices in more than 85 percent of births in this country. They do this despite any evidence the devices are beneficial in any way.

“Honestly, the technology got rolled out before we knew if it worked or not,” said one St. Louis obstetrician.

In use since the early 1970s, fetal monitors have failed to reduce the risk of either cerebral palsy or newborn deaths. In addition, fetal monitors have significantly increased the incidence of both Cesarean surgeries and forceps deliveries.

Cesarean surgeries are much more costly than traditional births and extend the new mother’s recovery time.

Fetal monitoring technology was supposed to reduce the risk of either cerebral palsy or newborn death by giving doctors early warning signs of when a baby was not receiving enough oxygen to its brain during child birth. The thinking was that the early warning would give doctors more time to take corrective action and save the baby from injury or death.

The flaw in that reasoning is that 70 percent of cerebral palsy cases are caused before labor begins. Only 4 percent of cerebral palsy is caused solely from a mistake during childbirth. The remaining 26 percent of cases are caused by a combination of factors that can occur before, during or after childbirth.

In summary, fetal monitoring has the potential to prevent only 4 percent of cerebral palsy children and it has failed to do even that. Physicians’ new understanding of the technology is not expected to result in a lower incidence of cerebral palsy, but hopefully it will result in a lower incidence of unnecessary, costly Cesarean surgeries.

The reason for such hope is that the new guidelines refine what once were two categories of fetal monitor data into three categories. Previously, data was categorized as “reassuring” and “nonreassuring” so doctors would err on the side of caution and often intervene in the “nonreassuring” cases when in fact the babies would have been perfectly healthy without intervention.

Now the categories are “normal,” “nonreassuring” and “abnormal.” The “normal” babies clearly do not require intervention like Cesarean surgery or forceps delivery. The new guidelines go as far as to say that “abnormal” babies do not require immediate intervention but should instead be quickly evaluated for other means of providing the baby with oxygen such as giving the mother oxygen, changing her position, treating her low blood pressure or ceasing the artificial induction of labor.

The “nonreassuring” category now calls for much more thorough evaluation of additional factors before doctors are encouraged to intervene. Previously, where a doctor was apt to intervene in “nonreassuring” cases based solely on the fetal monitoring data, the guidelines now call for doctors to “look at the entire clinical picture, not just the [fetal monitor data].”

The entire clinical picture includes things like the mother’s blood pressure, heart rate and temperature, what medicines she might have been given, the frequency of contractions and how fast labor is progressing.

Immediate delivery is discouraged by the guidelines so hopefully that will save future mothers from the pain and costs of unnecessary Cesarean surgery. Further refinements of the guidelines are expected to be released next year.

Some of you parents no doubt send your children to the same summer camp you attended as a youngster. For those parents who don’t already know what summer camp would be best for their kids, the Orlando Sentinel has published a summer camp guide full of details on which camps specialize in what activities.

Whether your child is interested in arts, athletics or science, there’s a camp for him or her. The Sentinel stresses its guide is not comprehensive and that camps can fill up quite quickly. So don’t delay.

Fortunately, the large majority of child injuries suffered at summer camp are your garden variety scrapes, bruises and maybe the errant bee sting. However, if a catastrophic injury does occur this summer, you’ll have many questions. The child injury lawyers of Zimmet & Quarles will listen to you and help provide some peace of mind. We’ll answer your questions and explain your options.

For more information on keeping your child safe around water this summer, watch this Child Injury Lawyer Video Blog.

Many people who write about birthing techniques, birth injuries or anything related with childbirth are very opinionated and biased. However, this blog author takes a very even handed approach and evaluates both sides of the argument.

Please visit this childbirth nurse blog. It’s well-written and informative. The author is a nurse who provides an insider’s account of childbirth that is very educational and fair.

New studies show that cerebral palsy Botox treatments have serious side effects even up to three weeks after the treatment. If your child is experiencing difficulty breathing, difficulty swallowing, muscular weakness, drooping eyelids, constipation, aspiration pneumonia, speech disorder, facial drooping, or double vision, seek immediate emergency medical attention.

This new warning is an update to a 2008 safety review of cerebral palsy Botox treatments and will be included on the label and patient information packet going forward.

Although the FDA never approved Botox for cerebral palsy pediatric patients, it is a very commonly used and widely accepted treatment  across the country. Cerebral palsy Botox treatments involve the injection of large amounts of Botox deep into spastic muscles for the purpose of relaxing them.

The problem noted in the new study is that the Botox spreads well beyond the spastic muscles and has drastic side effects. The most serious side effects include hospitalizations involving ventilatory support and death.

The FDA also requests that all side effects be reported through MedWatch Every report helps the next child.