Parenting

By Rebecca Knight

The Lancet, last month, retracted its controversial 1998 study that linked the measles, mumps and rubella (MMR) vaccine to autism.

To be clear: the only evidence that showed a connection between vaccinations and the neural development disorder has been formally expunged from the scientific record.

Here is a link to the FT’s article about the now discredited study:
Lancet retracts MMR link to autism

Margaret McCartney

The politician in the internet chat room: Gordon Brown made a few interesting pledges the other day in a Mother’s day web chat on the forum Netmums.

“So this week, for example, Andy Burnham will be setting out new plans to really change and reform maternity services. Over the next few years we want to see a legal right for mums to choose where they give birth, including home births for anyone who wants one. And we want to see services changed so that not just mums but dads can have a bed if they need to stay in hospital overnight after the birth of their baby. We have also set a goal to recruit an extra 4,000 midwives by 2012.”

A legal right to give birth where you want? Is this really a good idea? Starting a discussion about where best to book in to doesn’t seem to get off on the right foot when a clinical decision has been taken by a politician and there is a legal ultimatum.

By Rebecca Knight

My daughter woke up three days ago with a runny nose, a fever of 101, and a wheezy, puffing cough that made her sound as though she’d smoked a pack a day for the past thirty years. My girl – age 22 months – is precocious, but I was confident that she hadn’t been sneaking cigarettes.

So I did what any novice mother in my situation would do: I went straight to the internet. I logged on to my favourite medical site and dutifully typed in her symptoms. Immediately I got a diagnosis: croup.

“Croup is a condition that causes an inflammation of the upper airways, and it often leads to a barking cough or hoarseness especially when a child cries,” the site said. “Most cases of croup are caused by viruses, and it is most common in children 6 months to 3 years old, but can affect older kids, too.”

Margaret McCartney

A case control study in the British Medical Journal: Hazardous cosleeping environments and risk factors amenable to change: case-control study of Sudden Infant Death Syndrome in south west England examines the relationship between co-sleeping – sleeping next to your child – and sudden infant death syndrome.

Sids is relatively rare but devastating: and the cause is not yet fully understood. However, risk factors have been identified - the best known one was putting a baby to sleep face down. This used to be the done thing, however, it was subsequently shown to be postively dangerous, and the “back to sleep” information provided by health visitors has gone some way towards reducing deaths by Sids.

Margaret McCartney

Slings, pram-bikes, vibrating rocking cradles …

It’s hard to keep up with trends in child-rearing paraphernalia. When I bought a car seat for my first child, for example, there was hardly any choice. Most products were variations on a curved seat that put the infant in a sitting or flopping position. Now the new “must have” accessory is a car bed, a more rigid kind of affair which straps the child in so that he or she is flat.

Fashion for babies is a curious thing, often faddish and needlessly expensive. However, in the case of car beds, there seems to be evidence to suggest that the reclining baby is healthier than its propped-up counterpart. But is this enough for us to make the switch?

The remainder of the article can be read here. Please post comments below.

By Rebecca Knight

When my maternity leave ended, I hemmed and hawed over childcare options. My friends who had hired nannies conceded it was the more expensive route, but, they told me, children in daycare get sick more often, which means taking days off from work, and spending more time at the pediatrician’s office. That didn’t sound like fun.

My circle of daycare-devoted working mothers told me that it was not only the more economical solution, but that it was a boon to socialisation. They admitted their kids did seem to be afflicted with more colds and coughs compared with children who had nannies, but that these respiratory illnesses had a counterbalancing positive benefit: daycare kids have lower rates of asthma and allergies later in life. It sounded plausible at the time.

Margaret McCartney

“It won’t hurt, and it might even help.” So goes the philosophy which some people use to justify their use of complementary medicine. Some doctors accept this, thinking that it is good if people can exercise a bit of control in a difficult medical situation. Other more cynical types like me argue that the harm could still be present  – wasting time, resources or meaning that effective treatment was missed or delayed.

However another possibility has been raised by a paper in Human Reproduction -  Use of complementary and alternative medicines associated with a 30% lower ongoing pregnancy/live birth rate during 12 months of fertility treatment
The study followed a group of women having assisted reproduction over a 12 month period. 30% of women were using complementary/alternative medicine at the start. By the end of the year, 42.2% of these women were pregnant/given birth, versus 61.4% who hadn’t used CAM (complementary and alternative medicine) interventions.

So are alternative treatments harmful? There are at least two problems with the study: it was neither randomised nor double blind, but observational. There may have been a factor or factors associated with people using alternative interventions that made them less likely to concieve, which was not the fault of the alternative medicine itself.

Second, the researchers haven’t given full details of the interventions – CAM is a broad term. But the results are interesting, and the subject merits further investigation. The usual teaching to medical students is to only use in pregnancy what you know to be safe, or when you have carefully weighted up the pros and cons with the woman. This approach should apply to complementary interventions too.

By Rebecca Knight

What does it mean to lead a healthy life? Sure, we all have our peccadilloes – some of us smoke cigarettes, or eat too much fast food, others spend too much time on the couch, and not enough on the treadmill. (My own indulgences include too much sun, too much chocolate, and far too much red wine.)

But with apologies to John Maynard Keynes, we’re all dead in the long run, right? Do these sins against our own wellbeing make any real difference to our longevity? Some matter more than others, according to a report in the latest issue of Archives of Internal Medicine.

Researchers at the Centers for Disease Control and Prevention in Atlanta have determined that four lifestyle factors – never smoking, maintaining a healthy weight, exercising regularly and following a healthy diet -together appear to be related to as much as an 80 per cent reduction in the risk of developing the most common and deadly chronic diseases, such as cancer and diabetes, that account for most deaths.

Margaret McCartney

To have a baby or not? The National Childbirth Trust, a hardworking parenting charity, have been criticised for offering advice (now withdrawn) that women may wish to delay pregnancy until the swine flu pandemic is over. Various other agencies, including the Royal College of General Practitioners and the Department of Health, were quick to respond by saying that this was an over-reaction. And probably, it was.
 
The problem is that pregnant women and babies seem to have been amongst those most affected by the H1N1 influenza strain. So how are people meant to react? You can’t say that no risk to a baby or pregnant woman exists, only that the risk is, overall, very small. From what I can gather, the NCT did not say that women should delay pregnancy, rather that it was an option.
 
It seems that we have an ongoing problem with the way risk is viewed and managed, and it is this, rather than the thing we are meant to be afraid of, which is causing significant problems at the moment. Listening to the radio today, I was interested to find out more about developments in the influenza infection rate. Instead, there were back-to-back interviews about who was right and who was wrong.

Can we not just agree that there are quite a lot of things we are not sure about at the moment, some of which can be tested, some which can’t be quite so easily, and we are going to have to give people enough information to allow them to make reasonable decisions for themselves at present?

By Rebecca Knight

It’s a struggle that parents of small children face every day: How much should you feed your kids? How much should you coax them to eat certain foods that good for them? And at what point do you risk making food an “issue”? (At this point I ought to confess that for breakfast this morning my toddler ate: precisely four blueberries, a forkful of egg, two pretzels, and a sliver of angel food cake. I try to ensure she eats a healthy diet, but she is a willful child and – as every parent knows -you have to pick your battles.)

A study by researchers at the Warren Alpert Medical School of Brown University sheds some light on the matter. The study, published in the journal Obesity, finds that strict maternal feeding practices are not linked to child weight gain, and that some form of control may be necessary to help children eat well, and maintain healthy weight.

http://www.nature.com/oby/journal/vaop/ncurrent/abs/oby200954a.html

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Margaret McCartney is a Glasgow-based GP and FT Weekend columnist. She started writing for the Life and Arts section in 2005 and moved to the magazine in 2008. She also has her own blog: www.margaretmccartney.com/blog

Clive Cookson has been a science journalist for the whole of his working life. He joined the FT in 1987. Clive, the FT's science editor, picks out the research that everyone should know about. He also discusses key policy issues, from R&D funding to science education.

Andrew Jack is pharmaceuticals correspondent, covering the industry and public health issues. He has been a journalist with the FT for 19 years, based in London, Paris and Moscow

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