Has your baby been screened for hearing impairment?

October 25, 2010 by  
Filed under HEARING

Hearing impairment is something that is not easily discernible in adults, much more in babies and little children. Studies have shown that even the slightest hearing impairment can translate to behavioural and learning difficulties in children. Those who suffer from more serious hearing problems can face a lifetime of speech and language deficits, poor academic performance and social and psychological problems. This is because even though the child can hear, he or she is missing some details of what is going on the environment, but cannot understand what is going on. It is thus important that children be screened early in life for hearing problems.

Hearing impairments may be congenital or acquired. Thus, screening for hearing loss should start early, in fact, right after the delivery of the baby. This means that a baby is screened before it leaves the hospital or the maternity clinic.

The two most commonly used hearing screening procedures for babies are (source: American Speech-Language Hearing Association (ASLHA):

The initial result of the screening is “pass” or “fail”. Those who pass are considered free from hearing impairment till the next screening. Those who fail require an intensive evaluation by an expert such as an audiologist or an ear specialist. They will be closely monitored for progression of the impairment plus other auditory-related effects.

In the clinical report of the American Academy of Pediatrics (AAP) entitle “Hearing Assessment in Infants and Children: Recommendations Beyond Neonatal Screening”:

“… researchers have developed an algorithm to assist pediatricians determine the course of treatment when a hearing screening indicates hearing loss in children from infants to 18 years of age. Confirmed abnormal hearing test results require ongoing evaluation and intervention by a team of specialists including an audiologist, otolaryngologist, speech-language pathologists and teachers. At least one-third of children with hearing loss will also have a coexisting condition, so they should continue to be monitored for developmental and behavioral disorders and referred for additional evaluation when necessary.”

Pregnant and smoking? Read this!

February 25, 2010 by  

Pregnant, yet still smoking? Well, this latest report from the experts might motivate you to quit.

Swedish researchers compared the blood pressure of babies of moms show smoked during pregnancy, and babies of moms who did not. The results are really bad news for smoking moms and even worse news for their babies. Why bad news? Because these babies tend to suffer from a so-called circulatory dysfunction which results in abnormal control of the blood pressure during repositioning.

When we stand up, the heart rate normally increases, blood vessels constrict to keep the blood supply to the organs of the upper part of the body especially the brain and the heart, the blood pressure increases slightly.

In the first few months of their lives, babies are not able to change positions or sit/stand upright and have to be lifted for repositioning. During repositioning, the baby’s body, too, has to cope with the change in position with change in blood pressure.

The study involved 19 babies of non-smoking couples and 17 babies of moms who smoked 15 sticks of cigarettes per day on average. Both groups of babies were of normal weight at birth and were breastfed. A test for blood pressure control is by tilting the babies upright during sleep.

In this research, the babies were tilted up to an angle of 60 degrees and then returned to their lying position again. Blood pressure and heart rates were then measured during sleeping, during tilting, and after returning to the original lying position. The tilting test and the measurements were performed when the babies were aged 1 week, 3 months, and 1 year. The results of the study show:

  • Babies at age one week who were not exposed experience a 2% increase in blood pressure when tilted. At age one year, this increase in blood pressure is up to 10%, a normal increase correlated to the increase in size and mobility of the baby.
  • Babies who were exposed to tobacco in utero exhibit the opposite trend in blood pressure during tilting. A 10% increase was observed during the first week, which decreases down to 4% at age 12 months.
  • The researchers also observed that the heart rates of the exposed babies were abnormal and highly exaggerated in response to tilting at ages 3 months and one year.
  • When sleeping undisturbed, diastolic blood pressures of exposed babies were higher at 3 months, and the heart rates were 20% slower at 1 year compared to non-exposed babies.
  • When upright babies were returned abruptly to their lying position, blood pressure in non-exposed babies goes back to normal; blood pressure of tobacco-exposed babies goes up.

According to lead author Dr. Gary Cohen, senior research scientist in the Department of Women and Child Health at the Karolinska Institute in Stockholm, Sweden:

“Tobacco-exposed infants have a different profile. It’s surprising how early in life these functional abnormalities can be detected in the babies of smokers. The re-programming of the cardiovascular function is present at birth and is still present and even more dramatic at one year.”

In other words, the circulatory system of tobacco-exposed babies is not functioning properly and is hyperreactive in the first days of life, but becomes underreactive and less effective with time. The circulatory dysfunction and poor blood pressure control have some consequences later in life, including susceptibility to hypertension and other cardiovascular problems.

Swimming: good or bad for asthma?

December 21, 2009 by  
Filed under ASTHMA

It’s been freezing outside for days and the kids have eventually lost the enthusiasm for snow games. Now, what can we do in terms of exercise? The answer is swimming in indoor, heated swimming pools.

Aside from being a well-rounded physical exercise, swimming has been proven to be beneficial for those with asthma. An article in the journal Respirology reports that swimming is an effective non-pharmacological intervention against asthma for children.

The study by Taiwanese looked at school children aged 7 to 12 years old who were suffering from asthma. The study participants were split into 2 groups – one group received regular pharmacologic asthma treatments, the other underwent a six-week swimming program on top of their routine treatments.

The study results showed that

  • There were significant improvements in symptoms, hospitalizations, emergency room visits and school absenteeism the study participants.
  • There were also improvements in severity of asthma, mouth-breathing, snoring, chest deformity, self-confidence and general feelings of disadvantage among the participants.

According to lead author, Wang Jeng-Shing from the Taipei Medical University:

“Unlike other sports, swimming is unlikely to provoke asthma attacks. In addition to improving asthma, swimming promotes normal physical and psychological development, such as increasing lung volume, developing good breathing techniques and improving general fitness.”

“Not only is swimming an excellent form of exercise for children with asthma, the health benefits reaped continued to be observed for at least a year after the completion of the swimming program.”

However, swimming is not without its risks. Another study revealed that babies who start “swimming” before the age of 6 months are at an increased risk for developing asthma in childhood.

The Norwegian study looked at the data of about 30,000 participants of the Norwegian Mother and Child Study (MoBa) at the Norwegian Institute of Public Health (NIPH). The study revealed that:

  • 25% of children in the study started baby swimming between the age of 3 and 6 months.
  • There were differences observed with respect to lower respiratory tract infections, middle ear infection (otitis media) or tightness and wheezing in the chest between babies who went swimming at before the 6th month and those who did not.
  • A significant difference was found among children of mothers with asthma or allergies. 47% of these children who went swimming before the age of 6 months had tightness or wheezing in the chest compared to 44% who did not go swimming at such an early age.

I myself had enrolled my twin boys in a baby swimming program when they were aged 3 months. One of them developed wheezing a couple of months later. I do have a family history of asthma and allergies but I don’t know whether the swimming caused my child’s problem or not. However, my boys participated in a regular swimming course at age3.5 years and I definitely noticed and improvement in my wheezing son’s respiratory health. Again, I can’t be sure whether it’s swimming or other factors that caused the improvement.

So what is the link between swimming and wheezing?

Earlier studies indicated that there can be a link between baby swimming and airway infections in children. It has been suggested that indoor environmental factors (airway irritants) such as volatile chlorination products for indoor swimming pools can affect lung epithelium and contribute to the development of respiratory illnesses like asthma among children.

Photo credit: stock.xchng

Can baby fat predict obesity?

April 28, 2009 by  
Filed under OBESITY

baby-feetThe last three decades have witnessed the rapid increased incidence in obesity and scientists and health experts are scrambling to come up with ways and means to stop and reverse this trend. Recently, more and more evidence points to the fact that the problem of excess weight starts rather early in life. A recent study by Boston researchers suggests that the rate of weight gain during the first months of a baby’s life is a predictor of its risk for obesity later in life.

According to lead author Dr. Elsie Taveras, assistant professor in the Harvard Medical School Department of Ambulatory Care and Prevention

“There is increasing evidence that rapid changes in weight during infancy increase children’s risk of later obesity. The mounting evidence suggests that infancy may be a critical period during which to prevent childhood obesity and its related consequences.”

Dr. Taveras is also the co-director of the One Step Ahead Clinic, a pediatric overweight prevention program at Children’s Hospital Boston.

Previous studies on obesity risk concentrated on infants’ body weights. The current study took into account that weight gain is a dynamic process associated with growth, looked further and measured growth rates, e.g. weight gain, body length, and weight-for-length gain.

The connection between rapid infant weight gain and later obesity was striking, even after adjusting for factors such as premature babies or those underweight at birth. Take for example two infants with the same birth weight who, after six months, weigh 7.7 kg (16.9 pounds) and 8.4 kg (18.4 pounds), a 0.7 kg (1.5 pounds) difference. According to study estimates, the heavier of these two infants would have a 40% higher risk of obesity at age 3 (after adjusting for potential confounders).

Previous studies indicated that there is some confusion from infants’ growth charts, and that parents tend to be wrong in judging their children’s weight. Another study suggested that the “tipping point” for childhood obesity can be as early as age 2. The currents study indicates that weight gain in children should be managed appropriately as early as possible.

“At first it may seem implausible that weight gain over just a few months early in infancy could have long-term health consequences, but it makes sense because so much of human development takes place during that period-and even before birth,” says Matthew Gillman, director of the department’s Obesity Prevention Program. “Now we need to find out how to modify weight gain in infancy in ways that balance the needs of the brain and the body.”

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.