Gay Men, Moms Sue NJ Conversion Therapists for Fraud

Four gay men and two of their mothers filed a lawsuit today against a New Jersey conversion therapy group that claims to rid men of same-sex attractions and turn them straight.

The lawsuit, filed in Superior Court of New Jersey Hudson County, alleges that methods used by the Jersey City-based Jews Offering New Alternatives to Healing (JONAH) do not work and constitute fraud under the state's consumer protection laws.

Arthur Goldberg, JONAH's co-director, and Alan Downing, a 'life coach' who provides therapy sessions, were also named in the suit.

The plaintiffs include Michael Ferguson, Benjamin Unger, Sheldon Bruck and Chaim Levin, all of whom used the services of JONAH when they were in their teens or young 20s.

Two of the men's mothers, Jo Bruck and Bella Levin, who paid for therapy sessions that could cost up to $10,000 a year, were also plaintiffs.

One of the plaintiffs alleges that therapy sessions that involved a virtual 'strip tease' in front of an older male counselor, as well as reliving abuse and homophobia were 'humiliating.'

They are seeking declaratory, injunctive and an undisclosed amount of monetary relief, as well as court costs, according to the lawsuit.

The plaintiffs have received legal help from the Southern Poverty Law Center (SPLC), which claims in the lawsuit that conversion therapy is a dangerous practice that has been 'discredited or highly criticized' by every major American medical, psychiatric, psychological and professional organization.

Three of the young plaintiffs are from an ultra orthodox Jewish background; Ferguson came from a Mormon background and met Downing at a 'Journey Into Manhood' retreat, according to the lawsuit.

JONAH appears to cater to orthodox Jews, but its methods 'do not have a strong religious aspect,' according to SPLC lawyer Sam Wolfe.

The lawsuit alleges that some of the methods used included: telling boys to beat a pillow, the 'effigy of the client's mother,' with a tennis racket; encouraging 'cuddling' between younger clients and older male counselors; and even instructing attendees to remove their clothing and hold their penis in front of Downing.

Attendees were also subjected to ridicule as 'faggots' and 'homos' in mock locker room and gym class role playing, according to the lawsuit.

'It's definitely cruel and unusual and doesn't work,' said Wolfe. 'They are peddling bogus techniques that have no foundation in science and are basically ridiculous and even harmful.'

Wolfe paraphrased JONAH's message as: 'All you have to do is put in the work to overcome your sexual attractions. If you follow our program your true orientation emerges and will turn you into a straight person.'

'Often if what the conversion therapist tells them doesn't work, it's their fault,' Wolfe added.

In 2008, when the plaintiffs were seeking help from JONAH, the cost of an individual therapy session was $100 and for a group session, $60. JONAH also 'strongly pushed' attending weekend retreats that could cost as much as $700, said Wolfe.

Arthur Goldberg said he 'knows nothing about the lawsuit,' which was filed this morning, and referred ABCNews.com to JONAH's website.

'We have a lot of people who were a success and were healed,' he said of JONAH's 14 years in service. 'Hundreds of the clients we serve are satisfied ... Our therapy is very conventional.'

When asked about the group's practices, he said, 'I can't tell you about the methodology.' Goldberg admitted he had 'no background specifically in counseling.'

'I am the administrator,' he said. 'I used to teach family law.'

When asked about instructing boys to take off their clothes, he said, 'I know nothing about that.'

Goldberg also said he had 'no idea' how to reach Downing because he was an 'independent contractor.'

According to JONAH's mission statement on its website, the nonprofit group is 'dedicated to educating the world-wide Jewish community about the social, cultural and emotional factors which lead to same-sex attractions.'

'Through psychological and spiritual counseling, peer support, and self-empowerment, JONAH seeks to reunify families, to heal the wounds surrounding homosexuality, and to provide hope,' the statement reads.

JONAH's Goldberg, who runs the business side of the nonprofit, says on the website that 'change from homosexual to heterosexual is possible . homosexuality is a learned behavior which can be unlearned, and that healing is a lifelong process.'

According to the lawsuit, JONAH cites the 'scientific' work of Joseph Nicolosi, one of the primary proponents of conversion therapy and Richard A. Cohen, who was permanently expelled from the American Counseling Association in 2002 for 'multiple ethical violations.'

Nicolosi's methodology is based on the belief that a weak father-son relationship and a dominating mother contribute to homosexuality. He advocates 'rough and tumble games,' as well as father-son showers, according to the lawsuit.

Cohen uses a technique called 'bioenergetics' that include having male patients beat a pillow, which represents their mother, as a way of stopping same-sex attraction, according to the lawsuit. Conversion therapists also cite child abuse and bullying as a 'primary cause' of homosexuality, according to the lawsuit.

APA Calls Gay Conversion Therapy Risky

The American Psychiatric Association and the World Health Organization, among other mental health groups, have cited the potential risks of reparation therapy, including 'depression, anxiety [and] self-destructive behavior,' according to the lawsuit.

Chaim Levin, the most vocal of the plaintiffs, is now 23 and a gay rights advocate who writes a blog, Gotta Give 'Em Hope.

He grew up in a Jewish an ultra orthodox community in Brooklyn where religious leaders threw him out of the Hebrew-speaking yeshiva at the age of 17, when they learned he was gay.

Levin told ABCNews.com that he had been abused as a boy and that he was 'confused' by his sexuality and took a rabbi's advice and began 18 months of gay conversion therapy at JONAH.

[Levin filed a civil lawsuit against his cousin in July, alleging he was abused for three years from the time he was 6.]

When Levin met co-director Goldberg, he said the defendant told him JONAH could change his sexual orientation, 'as long as I tried hard enough and put enough effort into it.'

'He told me, 'You will marry a woman and have a straight life,'' said Levin.

'Given where I came from, with three older siblings who were married with kids and not knowing any gay people or English, I was sure I could change,' he said. 'That was the theology.'

Levin first did a retreat with Downing, then saw him weekly at therapy sessions in Jersey City.

'A lot of the therapy involves reliving the experience,' he said. Levin alleges he was forced to relive the sexual abuse by his cousin, 'with no counseling afterwards.'

But the most 'humiliating' experience, the one that Levin alleges made him quit therapy, was being asked by Downing to take off his clothes, article by article and told to touch his 'private parts' -- to hold his penis in front of a mirror to 'be in touch with my masculinity.'

'I told him I wasn't comfortable, but I desperately wanted to change and was ready to do anything,' said Levin. Afterward, he said he felt 'degraded and violated.'

Today, Levin no longer identifies as orthodox, but said his parents have been 'supportive' of the lawsuit.

Some Jewish denominations and many congregations are inclusive of homosexual congregants, and even New York's orthodox communiities are more open-minded now, according to Levin.

'I had gone for help and they had misrepresented themselves,' he said.



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U.S. kids getting recommended amount of sleep: study

NEW YORK (Reuters Health) - Children in the U.S. appear to be getting as much shut-eye as the Centers for Disease Control and Prevention (CDC) recommends, according to a new study.

'We can't say this is the amount that they should be sleeping,' said Jessica Williams, the lead author of the study and a graduate student at the University of California, Los Angeles.

'All we could really do is compare our estimated norms with what is recommended, and it seems like it falls pretty well in line with the recommendations,' she told Reuters Health.

Williams and her colleagues point out in their study, published in the Archives of Pediatrics and Adolescent Medicine, that there has been concern that U.S. kids are getting too little sleep.

Insufficient sleep has been tied to all sorts of issues in kids and teens, from behavior problems to heart health risks (see Reuters Health reports of October 2, 2012 and October 16, 2012).

But there isn't a lot of hard evidence on how much shut-eye children typically get, Williams said, so the group set out to get an estimate of average sleep duration from birth to age 18.

The researchers gathered data from a nationwide survey that has tracked families for decades.

For this study, they focused on parents' reports of their children's sleep, beginning in 1997.

At the time, 2,832 children were included. In 2002 and 2007 the families were surveyed again and there were 2,520 and 1,424 children included, respectively.

Dr. Maurice Ohayon, director of the Stanford Sleep Epidemiology Research Center in Palo Alto, California, said one of the big strengths of the study is that it tracked changes in sleep among the same children as they aged.

'We have an evolution of the sleep during the childhood,' said Ohayon, who was not involved in the study. 'That is the unique thing.'

Williams's team found that until their second birthday, babies in the study slept an average of 12 to 14 hours during each 24-hour period.

By age four that had dropped to about 11 hours of sleep and by age 10, to 10 hours. By age 16, kids were getting an average of about nine hours of sleep per night.

The findings suggest most kids' sleep habits are in step with government guidelines.

According to the CDC, toddlers should be getting 12 to 14 hours of sleep. Preschoolers should get 11 to 13 hours of sleep, and adolescents age 10 to 17 should get 8.5 to 9.5 hours.

The researchers didn't find any differences in the amount of sleep between boys and girls, and only a slight gap between white and Hispanic kids.

Hispanic children tended to sleep 19 minutes longer than white children after age nine, but Williams said that difference is too small to matter for individual kids.

Parent reports of how much sleep their kids get are not perfectly accurate, and they often can't describe the quality of sleep, such as whether kids wake up in the night. Williams said it's still possible individual children aren't sleeping enough, because the study could only measure reports of sleep duration, and not sleep quality.

Tracking sleep in a laboratory is more precise, but would cost too much for a study this size, said Ohayon.

He told Reuters Health the study still offers a good sense of how much sleep children typically get, which is valuable in helping to gauge whether a child has a sleep disorder.

'What we are hoping to do with these norms is give some sort of reference to be used by clinicians and parents to see if children fall far from average,' said Williams.

SOURCE: http://bit.ly/KEGTVv Archives of Pediatrics and Adolescent Medicine, online November 26, 2012.



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Bounce houses a party hit but kids' injuries soar

CHICAGO (AP) - They may be a big hit at kids' birthday parties, but inflatable bounce houses can be dangerous, with the number of injuries soaring in recent years, a nationwide study found.

Kids often crowd into bounce houses, and jumping up and down can send other children flying into the air, too.

The numbers suggest 30 U.S. children a day are treated in emergency rooms for broken bones, sprains, cuts and concussions from bounce house accidents. Most involve children falling inside or out of the inflated playthings, and many children get hurt when they collide with other bouncing kids.

The number of children aged 17 and younger who got emergency-room treatment for bounce house injuries has climbed along with the popularity of bounce houses - from fewer than 1,000 in 1995 to nearly 11,000 in 2010. That's a 15-fold increase, and a doubling just since 2008.

'I was surprised by the number, especially by the rapid increase in the number of injuries,' said lead author Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Amusement parks and fairs have bounce houses, and the playthings can also be rented or purchased for home use.

Smith and colleagues analyzed national surveillance data on ER treatment for nonfatal injuries linked with bounce houses, maintained by the U.S. Consumer Product Safety Commission. Their study was published online Monday in the journal Pediatrics.

Only about 3 percent of children were hospitalized, mostly for broken bones.

More than one-third of the injuries were in children aged 5 and younger. The safety commission recommends against letting children younger than 6 use full-size trampolines, and Smith said barring kids that young from even smaller, home-use bounce houses would make sense.

'There is no evidence that the size or location of an inflatable bouncer affects the injury risk,' he said.

Other recommendations, often listed in manufacturers' instruction pamphlets, include not overloading bounce houses with too many kids and not allowing young children to bounce with much older, heavier kids or adults, said Laura Woodburn, a spokeswoman for the National Association of Amusement Ride Safety Officials.

The study didn't include deaths, but some accidents are fatal. Separate data from the product safety commission show four bounce house deaths from 2003 to 2007, all involving children striking their heads on a hard surface.

Several nonfatal accidents occurred last year when bounce houses collapsed or were lifted by high winds.

A group that issues voluntary industry standards says bounce houses should be supervised by trained operators and recommends that bouncers be prohibited from doing flips and purposefully colliding with others, the study authors noted.

Bounce house injuries are similar to those linked with trampolines, and the American Academy of Pediatrics has recommended against using trampolines at home. Policymakers should consider whether bounce houses warrant similar precautions, the authors said.

___

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner



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Europe mulls banning 'boxes' for abandoned babies

BERLIN (AP) - German pastor Gabriele Stangl says she will never forget the harrowing confession she heard in 1999. A woman said she had been brutally raped, got pregnant and had a baby. Then she killed it and buried it in the woods near Berlin.

Stangl wanted to do something to help women in such desperate situations. So the following year, she convinced Berlin's Waldfriede Hospital to create the city's first so-called 'baby box.' The box is actually a warm incubator that can be opened from an outside wall of a hospital where a desperate parent can anonymously leave an unwanted infant.

A small flap opens into the box, equipped with a motion detector. An alarm goes off in the hospital to alert staff two minutes after a baby is left.

'The mother has enough time to leave without anyone seeing her,' Stangl said. 'The important thing is that her baby is now in a safe place.'

Baby boxes are a revival of the medieval 'foundling wheels,' where unwanted infants were left in revolving church doors. In recent years, there has been an increase in these contraptions - also called hatches, windows or slots in some countries - and at least 11 European nations now have them, according to United Nations figures. They are technically illegal, but mostly operate in a gray zone as authorities turn a blind eye.

But they have drawn the attention of human rights advocates who think they are bad for the children and merely avoid dealing with the problems that lead to child abandonment. At a meeting last month, the United Nations Committee on the Rights of the Child said baby boxes should be banned and is pushing that agenda to the European Parliament.

There are nearly 100 baby boxes in Germany. Poland and the Czech Republic each have more than 40 while Italy, Lithuania, Russia and Slovakia have about 10 each. There are two in Switzerland, one in Belgium and one being planned in the Netherlands.

In the last decade, hundreds of babies have been abandoned this way; it's estimated one or two infants are typically left at each location every year, though exact figures aren't available.

'They are a bad message for society,' said Maria Herczog, a Hungarian child psychologist on the U.N. committee. 'These boxes violate children's rights and also the rights of parents to get help from the state to raise their families,' she said.

'Instead of providing help and addressing some of the social problems and poverty behind these situations, we're telling people they can just leave their baby and run away.'

She said the practice encourages women to have children without getting medical care. 'It's paradoxical that it's OK for women to give up their babies by putting them in a box, but if they were to have them in a hospital and walk away, that's a crime,' Herczog said. She said the committee is now discussing the issue with the European Parliament and is also asking countries which allow the practice to shut them down.

Herczog also said it's wrong to assume only mothers are abandoning these children and that sometimes they may be forced into giving up children they might otherwise have kept. 'We have data to show that in some cases it's pimps, a male relative or someone who's exploiting the woman,' she said.

In some countries - Australia, Canada and Britain - it is illegal to abandon an infant anywhere. Yet, in the U.S. there are 'safe haven' laws that allow parents to anonymously give up an infant in a secure place like a hospital or police department. A handful of other countries including Japan and Slovakia have similar provisions.

Countries that support this anonymous abandonment method contend they save lives. In a letter responding to U.N. concerns, more than two dozen Czech politicians said they 'strongly disagreed' with the proposed ban. 'The primary aim of baby hatches, which (have) already saved hundreds of newborns, is to protect their right to life and protect their human rights,' the letter said.

However, limited academic surveys suggest this hasn't reduced the murder of infants. There are about 30 to 60 infanticides in Germany every year, a number that has been relatively unchanged for years, even after the arrival of baby boxes. That's similar to the per capita rate in Britain where there is no such option.

Across Germany, there is considerable public support for the boxes, particularly after several high-profile cases of infanticide, including the grisly discovery several years ago of the decomposed remains of nine infants stuffed into flower pots in Brandenburg.

Officials at several facilities with baby boxes say biological parents sometimes name the infant being abandoned. 'The girl is called Sarah,' read one note left with a baby in Lubeck, Germany in 2003. 'I have many problems and a life with Sarah is just not possible,' the letter said.

The secretive nature also means few restrictions on who gets dropped off, even though the boxes are intended for newborns. Friederike Garbe, who oversees a baby box in Lubeck, found two young boys crying there last November. 'One was about four months old and his brother was already sitting up,' she said. The older boy was about 15 months old and could say 'Mama.'

Still, Germany's health ministry is considering other options. 'We want to replace the necessity for the baby boxes by implementing a rule to allow women to give birth anonymously that will allow them to give up the child for adoption,' said Christopher Steegmans, a ministry spokesman.

Austria, France, and Italy allow women to give birth anonymously and leave the baby in the hospital to be adopted. Germany and Britain sometimes allow this under certain circumstances even though it is technically illegal. Eleven other nations grant women a 'concealed delivery' that hides their identities when they give birth to their babies, who are then given up for adoption. But the women are supposed to leave their name and contact information for official records that may be given one day to the children if they request it after age 18.

For German couple Andy and Astrid, an abandoned infant in a baby box near the city of Fulda ended their two-year wait to adopt a child nearly a decade ago.

'We were told about him on a Sunday and then visited him the next day in the hospital,' said Astrid, a 37-year-old teacher, who along with her husband, agreed to talk with The Associated Press if their last names were not used to protect the identity of their child. The couple quietly snapped a few photos of the baby boy they later named Jan. He weighed just over 7 pounds when he was placed in the baby box, wrapped in two small towels.

When Jan started asking questions about where he came from around age 2, his parents explained another woman had given birth to him. They showed him the photos taken at the hospital, introduced him to the nurses there and showed him the baby box where he had been left.

Earlier this year, the couple began the procedure to adopt a second child, a boy whose mother gave birth anonymously so she could give him up for adoption.

Astrid said Jan, now 8, loves football, tractors and anything to do with the farming that he sees daily in their rural community. She said it's not so important for her and her husband to know who his biological parents are.

But for Jan, 'it would be nice to know that he could meet them if he wanted to,' she said. 'I want that for him, but there is no possibility to find out who they were.'

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Medical writer Maria Cheng reported from London.



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Extra prenatal choline doesn't help kids' brains

NEW YORK (Reuters Health) - Taking extra choline during pregnancy does not improve babies' language and memory skills, according to a new study.

'I think eating the recommended amount of choline, which is just about a half of a gram a day for pregnant women, would probably do you well,' Dr. Steven Zeisel, the senior author of the study and a professor at the University of North Carolina, Chapel Hill, told Reuters Health. 'Going to high levels doesn't always give you improvement.'

The results contrast with earlier studies in animals showing that a choline boost in utero improves rodents' performance on memory tasks. Companies claim that choline pills support 'brain health,' along with the health of other organs, and sell choline supplements over the counter for about $9 for 100 250-milligram capsules.

Choline is an essential nutrient found in meat, eggs and milk, and during pregnancy and breastfeeding, large amounts of choline are delivered to the baby through the mother. Zeisel said it's possible that the women in the study who didn't take a choline pill were getting enough from their diet.

Earlier studies have found that pregnant women with very low levels of choline in their diet have a higher chance of delivering a baby with a birth defect (see Reuters Health report of September 25, 2009). And adults who eat a choline-rich diet perform better on memory tests (see Reuters Health report of November 23, 2011: http://reut.rs/swPWp3).

To see if adding extra choline during pregnancy can offer any benefits to babies, Zeisel and his colleagues asked 99 pregnant women to take six pills every day, beginning when they were 18 weeks pregnant and continuing until three months after the baby was born.

Fifty of the moms received fake pills containing corn oil, while 49 received pills with 833 milligrams (mg) of phosphatidylcholine, a form of choline.

The phosphatidylcholine pills added up to 750 mg of choline each day, the equivalent of 170 percent of the recommended level for pregnant women and 140 percent of the recommended daily amount for breastfeeding moms.

When the children were 10 and 12 months old, Zeisel's team gave them a battery of tests to measure short and long term memory, language skills and general development.

There were no differences between the two groups on any of the tests, the team reports in The American Journal of Clinical Nutrition.

TRACKED LONG ENOUGH?

Marie Caudill, a professor at Cornell University in Ithaca, New York, who was not involved in the current research, said the study was well conducted, but she offered a number of reasons that might explain the discrepancy between the animal studies and the current findings.

One possibility is that the babies were not tracked long enough to see any differences in their abilities.

'The animal studies demonstrated (that) supplementing the maternal diet with extra choline during pregnancy resulted in lasting beneficial effects on cognitive functioning in the adult offspring and prevented age-related cognitive decline,' Caudill told Reuters Health by email.

Additionally, the type of choline used - phosphatidylcholine - might be less effective than choline itself. (Zeisel's group chose not to use choline because it can result in a fishy body odor.)

In addition, the tests may not be 'sufficiently challenging,' Caudill added.

Zeisel agreed that perhaps as children age and start to perform more complex mental processing, it might be easier to measure if a child has a deficit or a strength.

For now, he said, there's no reason to use supplements during pregnancy to get extra choline, and women should refer to the U.S. Department of Agriculture's recommendations for how much choline they should get from their diet.

Zeisel and his colleagues are developing studies in Gambia, where dietary choline levels are known to be low, to see if supplementation there might make a bigger difference than in a region where choline intake appears to be sufficient.

SOURCE: http://bit.ly/SWJifr The American Journal of Clinical Nutrition, November 7, 2012.



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Antibiotics in pregnancy tied to asthma in children: study

(Reuters) - Children whose mothers took antibiotics while they were pregnant were slightly more likely than other children to develop asthma, according to a Danish study.

The results don't prove that antibiotics caused the higher asthma risk, but they support a current theory that the body's own 'friendly' bacteria have a role in whether a child develops asthma, and antibiotics can disrupt those beneficial bugs.

'We speculate that mothers' use of antibiotics changes the balance of natural bacteria, which is transmitted to the newborn, and that such unbalance bacteria in early life impact on the immune maturation in the newborn,' said Hans Bisgaard, one of the study's authors and a professor at the University of Copenhagen.

Previous research has linked antibiotics taken during infancy to a higher risk of asthma, although some researchers have disputed those findings.

To look for effects starting at an even earlier point, Bisgaard and his colleagues gathered information from a Danish national birth database of more than 30,000 children born between 1997 and 2003, and followed for five years.

They found that about 7,300 of the children, or nearly one quarter, were exposed to antibiotics while their mothers were pregnant. Among them, just over three percent, 238 children, were hospitalized for asthma by age five.

The study, which appeared in The Journal of Pediatrics, found that by contrast, about 2.5 percent, or 581 of some 23,000 children whose mothers didn't take antibiotics, were hospitalized with asthma.

After taking into account other asthma risk factors, Bisgaard's team calculated that the children who had been exposed to antibiotics were 17 percent more likely to be hospitalized for asthma.

Similarly, these children were also 18 percent more likely to have been given a prescription for an asthma medication than children whose mothers did not take antibiotics when they were pregnant.

His team also looked at a smaller group of 411 children who were at higher risk for asthma because their mothers had the condition. They found that these children were twice as likely as their peers to develop asthma too if their mothers took antibiotics during the third trimester of pregnancy.

Others said that it was possible that something besides the antibiotics was responsible, such as the illness the drugs were prescribed for.

'This study, it doesn't tell us whether it's the antibiotic use or whether it's the infection. That's one thing we can't decipher,' said Anita Kozryskyj, a professor at the University of Alberta who also studies the antibiotics-asthma link but wasn't involved in the new study.

The results don't suggest that women should avoid antibiotics since some infections can be quite dangerous to a fetus, she said, adding that Bisgaard's study suggests that the development of asthma might start before birth, something researchers hadn't studied very closely.

'We're beginning to appreciate that some of the origins of asthma and changes to the immune system, maybe they start earlier than right after birth,' she added. SOURCE: http://bit.ly/W9SnlJ (Reporting from New York by Kerry Grens at Reuters Health; editing by Elaine Lies)



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Antibiotics in pregnancy tied to asthma in kids

NEW YORK (Reuters Health) - Children whose mothers took antibiotics while they were pregnant were slightly more likely than other kids to develop asthma in a new Danish study.

The results don't prove that antibiotics caused the higher asthma risk, but they support a current theory that the body's own 'friendly' bacteria have a role in whether a child develops asthma, and antibiotics can disrupt those beneficial bugs.

'We speculate that mothers' use of antibiotics changes the balance of natural bacteria, which is transmitted to the newborn, and that such unbalanced bacteria in early life impact on the immune maturation in the newborn,' said Dr. Hans Bisgaard, one of the authors of the study and a professor at the University of Copenhagen.

Those effects on the immune system could lead to asthma later on, although it's still not clear how, said Anita Kozyrskyj, a professor at the University of Alberta who also studies the antibiotics-asthma link but wasn't involved in the new study.

Previous research has linked antibiotics taken during infancy to a higher risk of asthma, although some researchers have disputed those findings (see Reuters Health stories of May 17, 2011 and February 3, 2011).

To look for effects starting at an even earlier point in a baby's development, Bisgaard and his colleagues gathered information from a Danish national birth database of more than 30,000 children born between 1997 and 2003 and followed for five years.

They found that about 7,300 of the children, or nearly one quarter, were exposed to antibiotics while their mothers were pregnant. Among them, just over three percent (238 kids) were hospitalized for asthma by age five.

In comparison, about 2.5 percent, or 581 of some 23,000 kids whose mothers didn't take antibiotics were hospitalized for asthma.

After taking into account other asthma risk factors, Bisgaard's team calculated that the children who had been exposed to antibiotics were 17 percent more likely to be hospitalized for asthma.

Similarly, these children were also 18 percent more likely to have been given a prescription for an asthma medication than kids whose mothers did not take antibiotics when they were pregnant, according to findings published in The Journal of Pediatrics.

In an email to Reuters Health, Bisgaard said he expected to see a higher risk of asthma 'because the mother is a prime source of early bacterial colonization of the child, and antibiotics may (have) disturbed her normal bacterial flora.'

Bisgaard's team also looked at a smaller group of 411 kids who were at higher risk for asthma because their mothers had the condition and found these children were twice as likely as their peers to develop asthma too if their mothers took antibiotics during the third trimester of pregnancy.

Kozyrskyj, who is research chair of the Women and Children's Health Research Institute, said it's also possible that something other than the antibiotics are to blame for the findings in both groups of children - such as the illness that caused the mothers to take antibiotics.

'This study, it doesn't tell us whether it's the antibiotic use or whether it's the infection. That's one thing we can't decipher,' she told Reuters Health.

The results don't suggest that women should avoid taking antibiotics to try to reduce their kids' risk of asthma, Kozyrskyj emphasized.

Some infections can be quite dangerous to a fetus, and 'there are very good indications for these antibiotics,' she added.

Bisgaard agreed that women should be treated, 'but we see 1/3 of pregnant women in our region receiving treatments (often for urinary tract infections), which may reflect an uncritical use,' he wrote in an email.

Bisgaard said his group is also studying the types of bacteria in pregnant mothers and newborn children to get a better understanding of their role in asthma.

Kozyrskyj said Bisgaard's study suggests that the development of asthma might start before birth, something researchers hadn't studied very closely.

'We're beginning to appreciate that some of the origins of asthma and changes to the immune system, maybe they start earlier than right after birth. It might be happening in utero,' she said.

SOURCE: http://bit.ly/W9SnlJ The Journal of Pediatrics, online November 8, 2012.



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Smoking in pregnancy tied to lower reading scores

NEW YORK (Reuters Health) - Babies exposed to their mother's cigarette smoke in the womb later perform more poorly on reading comprehension tests, according to a new study.

'It's not a little difference - it's a big difference in accuracy and comprehension at a critical time when children are being assessed, and are getting a sense of what it means to be successful,' lead author Dr. Jeffrey Gruen of Yale University told Reuters Health.

In the study, researchers found that children born to mothers who smoked more than one pack per day struggled on tests specifically designed to measure how accurately a child reads aloud and if she understands what she read.

On average, children exposed to high levels of nicotine in utero -- defined as the minimum amount in one pack of cigarettes per day -- scored 21 percent lower in these areas than classmates born to non-smoking mothers. The difference remained even when researchers took other factors -- such as if parents read books to their children, worked in lower-paying jobs or were married -- into account.

Put another way, among students who share similar backgrounds and education, a child of a smoking mother will on average be ranked seven places lower in a class of 31 in reading accuracy and comprehension ability, said co-author Jan Frijters of Brock University in Ontario, Canada.

Previous studies have found smoking during pregnancy is linked to lower IQ scores and academic achievement, and more behavioral disorders. The authors found no reports so far that zeroed in on specific reading tasks like accuracy and comprehension in a large population.

The team, which published their results in The Journal of Pediatrics, pulled data from more than 5,000 children involved in the Avon Longitudinal Study of Parents and Children (ALSPC) study that began in the early 1990s in the UK. Only data from children with IQ scores of 76 and higher were used. An IQ score of 70 and below can be the sign of a mental disability.

UK researchers collected questionnaires from mothers before and after giving birth. This helps make the self-reported data more trustworthy, explained Sam Oh of the University of California, San Francisco, who wasn't involved with the work. If mothers knew their child's reading scores beforehand, they might subconsciously report more or less smoking.

'To me, this study suggests that the effects attributed to in utero smoking can in fact be attributed to the intrauterine environment, and not due to environmental differences that the children grow up in,' Oh told Reuters Health by email.

Large observational studies like this one call attention to patterns, but do not prove a direct cause-effect relationship between cigarette smoking and low reading scores.

Despite public health initiatives to discourage smoking, as many as one in six pregnant American women still light up, according to national surveys by the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services.

'That is a lot of children,' Dr. Tomás Paus of the University of Toronto told Reuters Health.

Paus added that the study tied the effects of low test scores to nicotine in cigarettes, which also produce other harmful chemicals and carbon dioxide. Either way, smoking while pregnant seems to put a baby at risk for negative health outcomes.

'We should not be happy with those rates. Smoking during pregnancy is preventable,' Paus said.

SOURCE: http://bit.ly/W7v2kM The Journal of Pediatrics, online November 5, 2012.



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Even moderate drinking in pregnancy may affect child's IQ

LONDON (Reuters) - Women who drink even moderate amounts of alcohol while pregnant may risk lowering child's intelligence levels, according to a study by British scientists.

Advice to pregnant women about drinking is contradictory, with some guidelines recommending no alcohol at all and others suggesting the odd drink now and then is safe.

But in a study described as 'hugely important' by one expert, researchers using genetic analysis of more than 4,000 mothers and children found that drinking between one and six units of alcohol a week during pregnancy can lead to lower Intelligence Quotient (IQ) scores by the time a child is eight.

'Even at levels of alcohol consumption which are normally considered to be harmless, we can detect differences in childhood IQ which are dependent on the ability of the fetus to clear this alcohol,' said Sarah Lewis of Bristol University, who led the study. 'This is evidence that even at these moderate levels, alcohol is influencing fetal brain development.'

This study used genetic data from women and children who were part of another study called the Children of the 90s study.

Since the individual genetic variations that people have in their DNA are not connected to lifestyle and social factors, this kind of study avoids potential complications.

Most previous studies have used observational evidence, but experts say this can be misleading because, for example, mothers who drink in moderation while pregnant are typically also well educated, have good diets and are unlikely to smoke - all factors linked to higher IQ in children and which could mask any negative effects of alcohol.

A U.S. study published in July found that older, educated women are more likely to drink while pregnant.

GENES AFFECT ALCOHOL METABOLISM

This study, published in the journal PLOS ONE on Wednesday, used a new technique analyzing the genetic variants which modify the effects of alcohol exposure levels.

When a person drinks alcohol, ethanol is converted to acetaldehyde by a group of enzymes, the researchers explained.

Variations in genes that 'encode' these enzymes lead to differences in a person's ability to metabolize ethanol, so in 'slow metabolizes', alcohol levels may be higher for longer than in 'fast metabolizes'. Scientists think fast ethanol metabolism protects against abnormal brain development because less alcohol goes to the fetus.

The mothers were asked to record their alcohol consumption at various stages during pregnancy, and one drink was specified as one unit of alcohol.

The results showed that four genetic variants in alcohol-metabolizing genes among the 4,167 children were strongly related to lower IQ at age eight. The child's IQ was on average almost two points lower per genetic variation they had.

The effect was only seen among children of women who were moderate drinkers and there was no effect evident in children of mothers who abstained during pregnancy. This strongly suggests it was exposure to alcohol in the womb that led to the difference in child IQ, the researchers said.

'This is a complex study but the message is simple: even moderate amounts of alcohol during pregnancy can have an effect on future child intelligence.' said Ron Gray of Oxford University, who was part of Lewis's team.

David Nutt, a professor of neuropsychopharmacology at Imperial College London who was not involved in the research, said it was 'a hugely important study from the best UK cohort that can study this question'.

'Even though the IQ effects are small, if at all possible women should avoid ethanol in pregnancy as it's a known toxin,' he said in an emailed comment.

(Editing by Paul Casciato)



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Kids with Down syndrome twice as likely to be heavy

NEW YORK (Reuters Health) - More than one in four children with Down syndrome in The Netherlands is overweight, a rate double that of Dutch youth without the developmental disability, according to a new study.

'We were alarmed by the high prevalence of overweight in children with Down syndrome,' said Dr. Helma van Gameren-Oosterom, the lead author of the study from the Netherlands Organization for Applied Scientific Research in Leiden.

'Of course we knew that the prevalence of overweight is rising; for Dutch standards a twofold level, however, was not expected.'

Previous studies have suggested children with Down syndrome are especially prone to being heavy. But researchers still aren't sure why that is, according to Dr. Sheela Magge, an endocrinologist at Children's Hospital of Philadelphia, who was not part of the new study.

Theories have ranged from physiological differences in metabolism or the way the body suppresses appetite to behavioral differences, such as in how much exercise children get, she said, but no studies have been able to pin down the definitive cause.

About 6,000 babies - or one in every 691 - are born with Down syndrome each year in the U.S., according to the Centers for Disease Control and Prevention.

For the latest study, the researchers compared growth patterns among 659 children with Down syndrome and no other health problems to general data on youth in The Netherlands.

By calculating kids' weight relative to their height - a unit called body mass index (BMI) - the research team determined which children were overweight and which were obese. The BMI cutoffs for obesity and overweight are different for each age in children.

Magge said they're not a perfect measure for children with Down syndrome because their body proportions are different than those of other children, but it's the best available yardstick for now.

Gameren-Oosterom and her colleagues found 25.5 percent of boys with Down syndrome were overweight and 4.2 percent were obese.

Among girls with the condition, 32 percent were overweight and 5.1 percent obese, they report in the medical journal Pediatrics.

In comparison, children in the rest of the Dutch population had much lower rates: for boys, 12.3 percent were overweight and 1.7 percent obese; for girls, 14.7 percent were overweight and 2.2 percent were obese.

Magge said researchers have also observed higher rates of overweight among children with Down syndrome in the U.S.

Gameren-Oosterom wrote in an email to Reuters Health that she and her colleagues suspect lifestyle has something to do with that pattern. Because it's harder for young people with Down syndrome to develop their motor skills, they may be less active.

Low muscle tone and poor coordination often accompany the disability as well, Magge told Reuters Health.

Her concern with so many kids being overweight is that as people with Down syndrome are living longer, 'we may start seeing more complications and comorbidities such as diabetes, cardiovascular disease (and) hypertension, all those things that we worry about in all of our obese adolescents.'

Gameren-Oosterom said it's difficult to develop a prevention or treatment strategy to target overweight and obesity in children with Down syndrome, given that the causes are unknown.

But like all youth, she added, those children will benefit from a healthy diet and sufficient exercise.

Magge said people with Down syndrome tend to prefer keeping strict routines, which could be something parents can take advantage of to help instill healthy habits.

'In adults it might be that if they get into a routine of eating healthy it's more likely to stick,' she said.

SOURCE: http://bit.ly/SnWv05 Pediatrics, online November 12, 2012.



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Nesquik Recall Q and A: Are Your Kids Safe?

Nestlé announced late last week a recall of Nesquik for possible Salmonella contamination. Promoted by the Nesquik Bunny, the chocolate milk flavoring is consumed primarily by children. Here's what you need to know to make sure your kids are safe from this Salmonella risk.

How Do I Know If My Nesquik Is Part of the Recall?

The Nesquik recall covers only chocolate powder in 10.9, 21.8 and 40.7 ounce canisters manufactured during October 2012. Any other Nesquik products are not subject to recall. According to CNN, 200,000 canisters of Nesquik are included in the recall.

Nesquik subject to the recall bears a Best Before date of October 2014. The applicable UPC codes and production codes include: for 40.7 ounce containers UPC 0 28000 68230 9 with production codes 2282574810 or 2282574820; for 21.8 ounce size, UPC 0 28000 68090 9 and production codes 2278574810, 2278574820, 2279574810, 2279574820, 2284574820, 2284574830, 2285574810, 2285574820, 2287574820, 2289574810, or 2289574820; and, for 10.9 ounce canisters, UPC 0 28000 67990 3 and product code 2278574810.

What About Ready-to-Drink Nesquik Served at My Kid's School?

In June, Nestlé went after the school lunch market by offering eight-ounce ready-to-drink Nesquik. If your child's school is serving ready-to-drink Nesquik, there's no cause for concern. The recall covers only the powder variety of Nesquik, not the ready-to-drink type.

What Led to the Nesquik Recall?

Nestlé identifies a supplier of calcium carbonate used in the drink powder as the culprit. The recall notice says Omya, Inc., notified Nestlé of its own product recall due to Salmonella concerns. There have been no reports of illness associated with the Nesquik recall, Nestlé says.

What Is Calcium Carbonate?

Calcium carbonate is an additive included in powdered products to prevent caking and/or to increase calcium content, according to Self.



If My Child Gets Sick, How Will I Know Whether or Not It's from Salmonella?

Salmonella infection symptoms include diarrhea, abdominal cramps, and fever. These normally develop within 72 hours of consuming contaminated food or drink. Most people who do contract salmonellosis get better in about a week without treatment. For infants, the elderly, pregnant women, and people with compromised immune systems, salmonellosis can be life threatening and medical treatment is advised.

Can I Get a Refund?

Yes. Return recalled Nesquik to the store where you bought it for a refund, or call Nestlé Consumer Services at (800) 628-7679.

Carol Bengle Gilbert writes about consumer issues for the Yahoo! Contributor Network.



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Study tentatively links flu in pregnancy and autism

NEW YORK (Reuters Health) - Kids whose mothers had the flu while pregnant were slightly more likely to be diagnosed with 'infantile autism' before age three in a new Danish study. But the children's overall risk for the developmental disorder was not higher than that of other kids.

Researchers said it's possible that activation of a mother's immune system - such as by infection with the influenza virus - could affect a fetus's developing brain. But they urged caution with the new findings, especially because of statistical limitations in their number-crunching.

'I really want to emphasize that this is not something you should worry about,' said lead author Dr. Hjordis Osk Atladottir, from the University of Aarhus.

'Ninety-nine percent of women with influenza do not have a child with autism,' she told Reuters Health. 'If it were me that was pregnant, I wouldn't do anything different from before, because our research is so early and exploratory.'

Her team's data came from a study that originally recruited more than 100,000 pregnant women in Denmark between 1996 and 2002. The women were called multiple times during their pregnancies, and once afterward, to ask about any new infections they had or medications they had taken.

The new report includes 96,736 kids born from that initial cohort who were between 8 and 14 years old at the time of the analysis.

Using a country-wide register of psychiatric diagnoses, Atladottir and her colleagues found that 1 percent of all kids were diagnosed with autism, including 0.4 percent with infantile autism - in which the main symptoms all show up before age three.

There was no link between a range of infections in pregnancy - including herpes, coughs and colds and cystitis - and the chance a baby would develop autism or infantile autism, according to the report published Monday in Pediatrics.

And among 808 women who reported having the flu while pregnant, there was no increased risk of autism in their children. However, seven of those babies, or 0.87 percent, were diagnosed with infantile autism, compared to the rate of 0.4 percent among kids in general.

There was also an increased - albeit sometimes borderline - risk of both autism and infantile autism in babies of women who had fevers for a week or more during pregnancy, as well as mothers who took some types of antibiotics.

Atladottir said there is some research in rodents suggesting women's activated immune cells can cross the placenta and affect chemicals in a fetus's brain. But how those findings apply to humans is still a question mark.

'It's all very unsure now - we don't really know anything,' she said.

In the United States, about one in 88 children is now diagnosed with autism or a related disorder.

One limitation of the new study, the researchers noted, is that they did 106 statistical tests comparing the risk of autism or infantile autism with various infections and drugs.

In medical research, a significant finding is typically considered one where there is less than a five percent likelihood the result would have occurred by chance.

But when so many calculations are done, scientists would expect that at least some would pass this test of significance, even if there is no real link between the pregnancy variables and autism.

In addition, women's flu reports weren't confirmed by doctors - and the frequency of mistaking the flu for another infection, or vice versa, is 'likely to be considerable,' the researchers noted.

Because of those limitations, Atladottir said the findings could encourage future research, but shouldn't be at the front of pregnant women's minds.

'We don't want to create panic,' she said.

Still, one expert who wasn't involved in the new study thought the researchers were 'soft peddling' their conclusions.

'It is highly recommended that women avoid infection during pregnancy, and there are a variety of very practical ways to decrease the likelihood of this,' Paul Patterson, who studies the immune system and brain development at the California Institute of Technology in Pasadena, told Reuters Health by email.

The U.S. Centers for Disease Control and Prevention recommend all women get a flu vaccine during pregnancy - in part because serious flu complications are more common in pregnant women.

But, said Patterson, 'It is also worth emphasizing that even though the risk (of infantile autism) is significantly increased, the risk is still quite low.'

SOURCE: http://bitly.com/kSEGVh Pediatrics, online November 12, 2012.



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Uncle Sam to Start Tracking Tobacco Use in Movies Aimed at Kids

Federal health authorities said Friday they will begin monitoring how well movie studios are doing to reduce depictions of smoking and other tobacco use in youth-rated movies.

Authorities at the Center for Disease Control and Prevention's Office on Smoking and Health said that voluntary efforts by movie studios to reduce tobacco use in youth-rated movies have been unimpressive. Data on tobacco use in movies will  be added to regular CDC reports to the public on smoking prevalence among youth and adults, total and per-capita cigarette consumption, and progress on tobacco control policies.

'We all have a responsibility to prevent youth from becoming tobacco users, and the movie industry has a responsibility to protect our youth from exposure to tobacco use and other pro-tobacco imagery in movies that are produced and rated as appropriate for children and adolescents,' said the lead author of the paper, Dr. Tim McAfee. 'Eliminating tobacco imagery in movies is an important step that should be easy to take.'

MORE: PG-13 Movies May Start Teens Smoking

Understanding what motivates kids to smoke is a high priority of public-health experts. According to the U.S. Department of Health and Human Services, more than 3,800 kids a day smoke their first cigarette. And, while smoking rates fell over the past 40 years, rates in both adults and youths have held steady in more recent years.

Previous research shows that kids who see smoking on television and in the movies are more likely to take up smoking. But depictions of smoking continue to turn up in youth-rated movies. Last year, the number of on-screen smoking scenes increased, according to a study published in the October issue of the journal Preventing Chronic Disease.

The data, from Thumbs Up! Thumbs Down!, a project of  Breathe California-Emigrant Trails, is based on tobacco incidents in top-grossing movies each year rated G, PG and PG-13. The study looked at 134 movies that were among the 10 top-grossing, youth-rated movies last year for at least one week.

The study found the number of tobacco incidents rose 3 percent (1,881 incidents) in 2011 compared to 2010 despite the fact that there were five fewer movies in the 2011 sample. The number of tobacco incidents per movie rose 7 percent over 2010 -- 13.1 incidents per movie in 2010 and 14 last year. The biggest increase in smoking depictions occurred in G and PG movies.

MORE: Smoking Rates Around the World Are Astronomical

And, while kids aren't supposed to see R-rated movies, smoking incidents in those films rose 7 percent in 2011, said the author of the study, Dr. Stanton A. Glantz, a professor of medicine for the Center for Tobacco Control Research and Education at the University of California, San Francisco. Glantz has been studying smoking in the movies for many years.

'There are going to be hundreds or thousands of kids who will take up smoking due to this backsliding,' Glantz told Take Part. 'There is a dose response here, too -- the more kids see, the more likely they will smoke.'

The uptick in smoking comes at a time when health professionals are unified behind the idea that kids are influenced by such depictions in the media. In a report released earlier this year, U.S. Surgeon General Regina Benjamin identified smoking in movies and tobacco-company advertising as the primary forces that cause kids to take up smoking.

'The evidence is sufficient to conclude that there is a causal relationship between depictions of smoking in the movies and the initiation of smoking among young people,' the Surgeon General's report noted. Images of smoking in the movies, 'are powerful because they can make smoking seem like a normal, acceptable, or even attractive activity. Young people may also look up to movie stars, both on and off screen, and may want to imitate behaviors they see.'

MORE: Teen Smoking an 'Epidemic,' Surgeon General Says

Previous studies have also showed that depictions of smoking in the movies are more likely to influence low-risk kids to smoke; 'the kids whose parents don't smoke or kids who do well in school,' Glantz says.

The increase in on-screen smoking is further disappointing because top officials for three studios -- Comcast (Universal), Disney and Time Warner -- had previously committed to reductions in smoking in their movies, Glantz says. Smoking in youth-rated movies declined from 2005 to 2010.

Among these companies with stated policies discouraging smoking in movies, the percentage of movies that were tobacco-free declined by 17 percent from 2010 to 2011.

'A few studios had taken the lead in reducing the amount of smoking in their films,' Glantz says.  'They accomplished it and showed it could be done. But now there is this serious back-sliding. I don't know what accounts for that.  These three studios are now about as bad as the studios that hadn't made a lot of progress. I don't know what happened.'

The Walt Disney Company 'actively seeks to limit the depiction of smoking in

movies marketed to youth,' according to a statement released by the company to Take Part.

MORE: U.S. Appeals Court Strikes Down Graphic Cigarette Warning Labels

'Disney discourages depictions of cigarette smoking in movies produced in the United States for which a Disney entity is the sole or lead producer and which are released either as a Touchstone movie or Marvel movie, and seeks to limit cigarette smoking in those movies that are not rated "R" to: scenes in which smoking is part of the historical, biographical or cultural context of the scene or is important to the character or scene from a factual or creative standpoint, or to scenes in which cigarette smoking is portrayed in an unfavorable light or the negative consequences of smoking are emphasized,' according to the statement.

The company also said it prohibits tobacco product placement and promotions and will  place anti-smoking public service announcements on DVD's of new and newly re-mastered titles, not rated "R," that depict cigarette smoking and will work with theater owners to encourage the exhibition of an anti-smoking public service announcement before the theatrical exhibition of any such movie.

But the World Health Organization and other public health groups have recommended formal policies aimed at eliminating smoking in the movies, McAfee noted.

MORE: Teens: Smoking Less, Calling It 'Scummy' More

The Glantz study raises 'serious concerns about this individual company approach,' he wrote. 'This difference suggests that individual company policies may not be sufficient to sustain a reduction in youth exposure to tobacco-use and other pro-tobacco imagery in movies and that more formal, industry-wide policies are needed.'

Glantz has long argued for a modernized rating system to give movies with any tobacco use an R rating, unless the presentation of tobacco 'clearly and unambiguously reflects the dangers and consequences of tobacco use,' he says. Other options to discourage smoking are to run anti-smoking messages prior to the movie and persuading movie studies to adopt policies to certify they receive no payments for depicting particular tobacco brands in their movies.

'The MPAA has refused to address this issue in a meaningful way by giving movies with smoking an R rating,' Glantz says. 'They have never rated a single movie R for smoking. The goal here is to get smoking out of the movies being shown to kids.'

Question: Should movies that depict smoking receive an R rating? Tell us what you think in the comments.

---

Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.



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Malaria vaccine disappoints in trial in African babies

LONDON (Reuters) - A GlaxoSmithKline experimental malaria vaccine touted as a new weapon in the fight to eradicate the disease proved only 30 percent effective when given to babies as part Africa's largest ever clinical trial.

The surprisingly poor result for the world's first potential vaccine against malaria leaves uncertain whether it can have a useful role in fighting the mosquito-borne disease that kills hundreds of thousands of children a year.

Philanthropist Bill Gates, who has helped fund its development, said further data was needed to determine whether and how the vaccine might be used.

'The efficacy came back lower than we had hoped, but developing a vaccine against a parasite is a very hard thing to do,' he said in a statement.

Results from the final-stage trial with 6,537 babies aged six to 12 weeks showed the vaccine provided 'modest protection', reducing episodes of the disease by 30 percent compared to immunization with a control vaccine, researchers said on Friday.

That efficacy rate one year after vaccination is less than half the 65 percent reported in a smaller mid-stage trial in 2008 that followed babies of a similar age for six months.

It's also a lot less than the 50 percent seen last year in Phase III trial data from five to 17 month-olds.

Vaccinating babies, rather than toddlers, is the preferred option, since the new vaccine could then be added to other routine infant immunizations. A separate program for older children would involve a lot of extra costs.

Despite the limited success, Britain's top drugmaker said it would push ahead with developing the vaccine, called RTS,S or Mosquirix, and GSK Chief Executive Andrew Witty said he still believed it would be an important tool in fighting malaria.

'We've been at this for 30 years, and we're certainly not going to give up now,' Witty told a conference call.

GSK does not expect to make any profit from the vaccine, which would only be sold in poor countries. Witty reiterated a promise that if RTS,S is ultimately approved for market, it would be priced at cost of manufacture plus a 5 percent margin, and the margin would be reinvested by GSK in malaria research.

Given the target market, it is governments and international groups that will fund the vaccine's roll-out, and they now need more positive data before deciding whether it is worth buying.

'We will have to have more information to give us a clearer idea as to how useful this vaccine will be,' said Seth Berkley, CEO of the GAVI Alliance, which funds bulk-buy vaccination programs for poorer nations.

In particular, Berkley told Reuters he wanted to see longer-term data, including the effect of booster shots, and an analysis of how the vaccine performed in different settings.

Details of the malaria trial, which is Africa's largest ever clinical trial involving almost 15,500 children in seven countries, were presented at a medical meeting in Cape Town and published online by the New England Journal of Medicine.

Witty said he would have liked to have seen efficacy rates of around 50 percent in infants, but stressed that more data would become available before the trial ends in 2014 which may throw more light on why rates of success are so variable.

'It's not as positive as we all might have hoped ... but it may take us down the road where we start to think about the vaccine for specific types of patients in specific types of areas,' he said. 'It may open up a more customized approach to how this potential vaccine gets used.'

Malaria is caused by a parasite carried in the saliva of mosquitoes. It is endemic in more than 100 countries worldwide and infected around 216 million people in 2010, killing around 655,000 of them, according to the World Health Organisation.

Control measures such as insecticide-treated bednets, indoor spraying and anti-malaria drugs have helped cut malaria cases and deaths significantly in recent years, but experts say an effective vaccine is vital to completely overcome the disease.

Scientists around the world are working on other potential malaria vaccines but RTS,S is by far the furthest ahead in development.

(Editing by Mark Potter)



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Malaria vaccine a letdown for infants

LONDON (AP) - An experimental malaria vaccine once thought promising is turning out to be a disappointment, with a new study showing it is only about 30 percent effective at protecting infants from the killer disease.

That is a significant drop from a study last year done in slightly older children, which suggested the vaccine cut the malaria risk by about half - though that is still far below the protection provided from most vaccines. According to details released on Friday, the three-shot regimen reduced malaria cases by about 30 percent in infants aged 6 to 12 weeks, the target age for immunization.

Dr. Jennifer Cohn, a medical coordinator at Doctors Without Borders, described the vaccine's protection levels as 'unacceptably low.' She was not linked to the study.

Scientists have been working for decades to develop a malaria vaccine, a complicated endeavor since the disease is caused by five different species of parasites. There has never been an effective vaccine against a parasite. Worldwide, there are several dozen malaria vaccine candidates being researched.

In 2006, a group of experts led by the World Health Organization said a malaria vaccine should cut the risk of severe disease and death by at least half and should last longer than one year. Malaria is spread by mosquitoes and kills more than 650,000 people every year, mostly young children and pregnant women in Africa. Without a vaccine, officials have focused on distributing insecticide-treated bed nets, spraying homes with pesticides and ensuring access to good medicines.

In the new study, scientists found babies who got three doses of the vaccine had about 30 percent fewer cases of malaria than those who didn't get immunized. The research included more than 6,500 infants in Africa. Experts also found the vaccine reduced the amount of severe malaria by about 26 percent, up to 14 months after the babies were immunized.

Scientists said they needed to analyze the data further to understand why the vaccine may be working differently in different regions. For example, babies born in areas with high levels of malaria might inherit some antibodies from their mothers which could interfere with any vaccination.

'Maybe we should be thinking of a first-generation vaccine that is targeted only for certain children,' said Dr. Salim Abdulla of the Ifakara Health Institute in Tanzania, one of the study investigators.

Results were presented at a conference in South Africa on Friday and released online by the New England Journal of Medicine. The study is scheduled to continue until 2014 and is being paid for by GlaxoSmithKline and the PATH Malaria Vaccine Initiative.

'The results look bad now, but they will probably be worse later,' said Adrian Hill of Oxford University, who is developing a competing malaria vaccine. He noted the study showed the Glaxo vaccine lost its potency after several months. Hill said the vaccine might be a hard sell, compared to other vaccines like those for meningitis and pneumococcal disease - which are both effective and cheap.

'If it turns out to have a clear 30 percent efficacy, it is probably not worth it to implement this in Africa on a large scale,' said Genton Blaise, a malaria expert at the Swiss Tropical and Public Health Institute in Basel, who also sits on a WHO advisory board.

Eleanor Riley of the London School of Hygiene and Tropical Medicine, said the vaccine might be useful if used together with other strategies, like bed nets. She was involved in an earlier study of the vaccine and had hoped for better results. 'We're all a bit frustrated that it has proven so hard to make a malaria vaccine,' she said. 'The question is how much money are the funders willing to keep throwing at it.'

Glaxo first developed the vaccine in 1987 and has invested $300 million in it so far.

WHO said it couldn't comment on the incomplete results and would wait until the trial was finished before drawing any conclusions.

___

Online:

www.nejm.org



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Iron, omega-3s tied to different effects on kids' brains

NEW YORK (Reuters Health) - For children with low stores of two brain-power nutrients, supplements may have different, and complex, effects, a new clinical trial suggests.

Iron deficiency is the most common nutritional deficiency worldwide, affecting about 2 billion people, according to the World Health Organization.

Poor children in developing countries are at particular risk for shortfalls in iron, as well as other nutrients, including the omega-3 fats found largely in oily fish.

So the new study looked at the effects of giving 321 schoolchildren in South Africa either supplements containing iron, omega-3s or both. All of the kids had low levels of both nutrients, which are vital for children's growth and healthy brain development.

After about eight months, researchers found varied changes in the kids' memory and learning abilities.

In general, children given iron showed improvements on tests of memory and learning. That was especially true if they had outright anemia - a disorder wherein the blood's oxygen-carrying capacity is reduced, causing problems like fatigue and difficulty with concentration and memory.

For example, on a memory test, anemic kids given iron were able to recall an extra two words out of 12.

In contrast, there was no overall benefit linked to omega-3 supplements. And when the researchers zeroed in on kids with anemia, those who used omega-3s did worse than before on one test of memory.

Then there were the children with clear iron deficiency, but not anemia. Of those kids, girls who got omega-3s fared worse, while boys improved their test scores.

What it all means for kids with nutritional deficiencies is unclear, according to lead researcher Jeannine Baumgartner, of North-West University in Potchefstroom, South Africa.

One limitation of the study, she said in an email, is that the number of children in each group her team analyzed was small. There were 67 kids with anemia, for example.

Thus, 'the results need to be interpreted cautiously,' Baumgartner told Reuters Health in an email.

There are still a lot of questions, according to Baumgartner, whose group's findings are published in the American Journal of Clinical Nutrition.

The children in this study were 6 to 11 years old. But, Baumgartner said, animal research suggests brain deficits that take shape early in life might not be reversible.

'The question arises whether supplementation during school age might be too late to achieve beneficial effects on cognitive performance,' she said.

Still, the omega-3 findings are consistent with some recent animal research. Baumgartner said her team found that in rats deficient in both iron and omega-3s, giving either supplement alone seemed to worsen the animals' memory performance. The picture was better, though, when the rats were given both iron and omega-3s.

In children, things are more complicated. Other nutritional deficiencies, as well as exposure to toxins like lead and the general effects of poverty could all dampen kids' brain development, Baumgartner pointed out.

'We believe that more research is needed to investigate the biological and functional links between nutrients essential for brain development and cognitive functioning,' she said.

Since this study focused on impoverished children with low iron, and possibly other nutritional deficiencies, the results cannot be extended to children in general, according to Baumgartner.

In the U.S., recommendations call for babies to get an iron test during the first year of life to check for deficiencies. For healthy kids older than six months, the recommended iron intake varies from 7 to 15 mg of iron per day, depending on their age and sex.

There is a risk from getting too much iron and experts tell parents to ask their doctor before giving children iron supplements.

The current study was partly funded by Unilever, which makes omega-3-enriched spreads. Paul Lohmann GmbH provided the iron supplements, and Burgerstein AG provided the omega-3s.

SOURCE: http://bit.ly/RIna8G American Journal of Clinical Nutrition, online October 24, 2012.



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Modest results in program to reduce kids' screen time

NEW YORK (Reuters Health) - A program aimed at reducing the number of hours young children spent in front of a screen didn't accomplish that goal, but it did cut back on the meals they ate in front of a television, a new study found.

That's good news according to the lead author, because people tend to eat more and eat unhealthy food while watching television.

'The relationship between screen time and obesity is linked to eating in front of a screen,' said Dr. Catherine S. Birken, a pediatrician at The Hospital for Sick Children in Toronto.

In addition to its association with obesity, the study's researchers say screen time - whether it is in front of a television, computer or video game console - has been linked to children having problems with language development and behavior, and their likelihood of cigarette smoking.

'These are really important health outcomes in young children,' said Birken. 'So we need to understand what works and what doesn't.'

So far, studies scrutinizing various methods of cutting back on kids' screen time have found little success.

However, Birken told Reuters Health that a couple of past studies did find promising results in preschool children, which is why her team decided to test a practical approach in that age group.

For their study, published in the journal Pediatrics on Monday, Birken and her colleagues recruited three-year-old children from a network of clinics around the Toronto area during their annual checkups. The children and their parents were randomly assigned into one of two groups.

In an intervention group of 64 children, the parents were told about the health impact of screen time on kids and how to reduce their children's hours.

Some of the techniques included removing televisions from the kids' bedrooms and not allowing them to eat with the television on.

Those families, along with a control group of 68 similar children and their parents, were also educated about safe media use, such as rating systems, Internet safety and violent programming.

The researchers then looked to see if the children's viewing or eating habits changed when they returned for a checkup a year later.

'TAKING IT SERIOUSLY'

Overall, the amount of time the children spent in front of a screen did not significantly differ between the two groups.

At the end of the study, the children in both groups spent between 60 and 65 minutes in front of a screen on weekdays. On the weekends, they spent between 80 and 90 minutes in front of a screen.

There also wasn't a difference in the children's BMI scores - a measure of weight in relation to height - between the start and end of the study. However, Birken said (for statistical reasons) she would only expect to see that in a larger group of children.

But, there was a statistically significant difference in the number of meals the children in the intervention group ate in front of the television.

At the start of the study, each group of kids ate about two meals with the television on daily. A year later, that number remained the same for the control group, but fell to about 1.6 for the intervention group.

That, the researchers note, works out to be at least two fewer meals per week in front of the television.

'I don't think there is much harm in turning the TV off during meals. I think that is a good message either way,' said Birken.

But, she added that her team would have liked to see the kids spending less time in front of a television. She said it could be that the program needs to be spread out across society, including the children's doctors and teachers.

Dayna M. Maniccia, an assistant professor at the University of Albany who has researched screen time interventions, said even if the study didn't show a reduction in screen time, it makes people think about it.

'The new study is great because it means that people are looking at this and pediatricians are taking it seriously,' said Maniccia.

SOURCE: http://bit.ly/uFc4g2 Pediatrics, online November 5, 2012.



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Nurses Who Saved NICU Babies Remember Harrowing Hurricane Night

Nurses at the Neonatal Intensive Care Unit at New York University's Langone Medical Center have challenging jobs, even in the best of times. Their patients are babies, some weighing as little as 2 pounds, who require constant and careful care as they struggle to stay alive.

On Monday night, as superstorm Sandy bore down on Manhattan, the nurses' jobs took on a whole new sense of urgency as failing power forced the hospital's patients, including the NICU nurses' tiny charges, to evacuate.

'20/20' recently reunited seven of those nurses: Claudia Roman, Nicola Zanzotta-Tagle, Margot Condon, Sandra Kyong Bradbury, Beth Largey, Annie Irace and Menchu Sanchez. They described how they managed to do their jobs - and save the most vulnerable of lives - under near-impossible circumstances.

On Monday night, as Sandy's wind and rain buffeted the hospital's windows, the nurses were preparing for a shift change and the day nurses had begun to brief the night shift nurses. Suddenly, the hospital was plunged into darkness. The respirators and monitors keeping the infants alive all went silent.

For one brief moment, everyone froze. Then the alarms began to ring as backup batteries kicked in. But the coast wasn't clear - the nurses were soon horrified to learn that the hospital's generator had failed, and that the East River had risen to start flooding the hospital.

'Everybody ran to a patient to make sure that the babies were fine,' Nicola Zanzotto-Tagle recalled. 'If you had your phone with a flashlight on the phone, you held it right over the baby.'

For now, the four most critical patients - infants that couldn't breathe on their own - were being supplied oxygen by battery-powered respirators, but the clock was ticking. They had, at most, just four hours before the machines were at risk of failing.

Annie Irache tended to the most critical baby -- he had had abdominal surgery just the day before - as an evacuation of 20 NICU babies began.

'[He] was on medications to keep up his blood pressure,' Irache said, 'and he also had a cardiac defect, so he was our first baby to go.'

One by one, each tiny infant, swaddled in blankets and a heating pad, cradled by one nurse and surrounded by at least five others, was carried down nine flights of stairs. Security guards and secretaries pitched in, lighting the way with flashlights and cell phones.

The procession moved slowly. As nurses took their careful steps, they carefully squeezed bags of oxygen into the babies' lungs.

'We literally synchronized our steps going down nine flights,' Zanzotto-Tagle said. 'I would say 'Step, step, step.'

With their adrenaline pumping, the nurses said, it was imperative that they stay focused.

'We're not usually bagging a baby down a stairwell ... n the dark,' said Claudia Roman. 'I was most worried about, 'Let me not trip on this staircase as I'm carrying someone's precious child, because that would be unforgivable.'

When the medical staff and the 20 babies emerged, a line of ambulances was waiting. A video of Margot Condon cradling a tiny baby as she rode a gurney struck a chord worldwide. But Condon said she had a singular goal.

'I was making sure the tube was in place, that the baby was pink,' she said. 'I was not taking my eyes off that baby or that tube.'

Like other nurses, she did not feel panic. Her precious patient helped keep her calm.

'[Babies] love to be held, so every time I would look down at the baby, the baby had his little hand on my chest, like 'And this is good!''

Langone patients were evacuated to various New York hospitals, including Mount Sinai Medical Center, where mother Luz Martinez wrapped nurse Beth Largey in an embrace. Largey had carried her 2-pound baby boy to safety.

In Montefiore Hospital in the Bronx, another mom tearfully expressed her gratitude to Sandra Kyong Bradbury, who ensured the safe evacuation of a baby named Jackson.

'I'm just so thankful,' she said.

The nurses would later receive praise from President Obama, who said they represented the 'brightest in America.'

Many others call them heroes.

Asked what they believed made a hero, they gave responses such as 'keeping calm in the face of adversity' and 'teamwork.'

'We take care of (the babies) every day,' said Kyong Bradbury. During the storm, she said, 'it was in extreme circumstances.'

'You step up,' she said, 'and I think that's what makes a hero.'



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Living at high altitude tied to developmental delay

NEW YORK (Reuters Health) - South American babies and toddlers living at high altitude were more likely to score poorly on early tests of brain development, in a new study.

Of all kids age three months to two years, one in five was at high risk of developmental delays, according to tests done at their pediatricians' offices. That rose to between one in three and one in four for those who lived above 2,600 meters, or 8,530 feet.

Because there is less oxygen at higher elevations, researchers said blood flow in the uterus may also be decreased at altitude - which could impact the brain of a developing fetus.

'The findings emphasize the need for health care providers and policy-makers to recognize that altitude may increase developmental risks not just for physical growth, as has been reported, but for neurologic and cognitive development,' wrote George Wehby from the University of Iowa in Iowa City, who conducted the research.

His study involved over 2,000 young kids evaluated at offices in Argentina, Brazil, Bolivia, Chile and Ecuador in 2005 and 2006.

The babies and toddlers were all given a series of problem-solving and motor tasks to complete, which their doctors used to measure which ones might be at risk for delayed development.

Wehby found that on average, for every 100-meter (328-feet) increase in elevation, kids were 2 percent more likely to be judged at high risk of future developmental problems.

Compared to kids living below 800 meters (2,625 feet), those above 8,530 feet were twice as likely to be at high risk, according to their pediatricians' evaluations.

The study, funded by the National Institutes of Health, is published in The Journal of Pediatrics.

All of the babies in Bolivia lived above the 8,530-foot cut-off, and all the kids in Argentina, Brazil and Chile lived below it. Ecuador was the only country in the study that included kids from both high- and low-altitude regions.

Of the largest cities in the United States, Albuquerque has a high point of 6,120 feet and Denver of 5,470 feet. Many Western states - including California, Colorado, Nevada and Utah - have regions above 10,000 feet.

However, it's hard to know whether the results apply to other communities at high elevation, according to Alexis Handal, an epidemiologist from the University of New Mexico in Albuquerque, who does her research in Ecuador.

'We're starting to realize there's such a complicated social context within which these populations live that it's very hard to look at one area and try to generalize to other areas,' Handal, who wasn't involved in the new study, told Reuters Health.

For example, she said, parents' work hours, whether families have access to nutritious food and what environmental toxins communities might be exposed to can all interact with factors like altitude to influence maternal and child health.

'Perhaps what we also have to focus on is. how can we also develop programs that promote infant development, that help families?' she added.

Wehby said in the study that babies born at higher elevations may be helped by earlier health screening to make sure they're developing normally.

But he also pointed to the need for more research on why altitude may affect development - and whether similar patterns apply to kids in other high-altitude regions.

SOURCE: bitly.com/SsOh9z The Journal of Pediatrics, online October 22, 2012.



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