Author: Children’s Hospital Boston staff

Other stories we’ve been reading:

More high school athletes are using fitness supplements with knowledge of their harmful effects. Parents don’t have to be fit in order for their kids to be fit – supporting your kids’ physical activity is what motivates them to be physically fit.

Scheduling recess before lunch is helping students and teacher alike. Menus with calorie listings have parents picking healthier options for their kids but not necessarily for themselves.

Parents who feel burned out at work are more likely to have kids who feel burned out at school. If parents use complementary or alternative therapies, their children are more likely to use them too. [Read our blog post on insurance coverage for alternative therapies.] Did you know that your child is more likely to have a mental disorder if you –as a parent – are bipolar?

High cholesterol is putting 20 percent of teens at risk for heart disease. Healthy kids are more likely to die from ecstasy use than regular drug users. If your child smokes cigarettes, it’s much more likely that pot is next.

Toilet seat dermatitis is on the rise. Vaccinating babies against rotavirus could save two million lives a year. [Read our blog post on this year’s updated immunization schedule.] Female teachers might pass on math anxiety to girl students.

Teen pregnancies and abortions are on the rise. Parents shouldn’t be concerned if their children hear voices. There’s a new wheelchair that powered by the user’s tongue.

Media expert Michael Rich, MD, MPH, director of the Center on Media and Child Health at Children’s Hospital Boston, answers your questions about media use. Last week, he discussed a report detailing just how much media kids are using.

Here’s this week’s question:

Here’s a quick look at what Thrive was up to last week.

Researchers have found that morphine can lesson PTSD before it even strikes. Graco recalled 1.5 million strollers. Schools are starting to evaluate students’ weights. Children’s Judith Palfrey, MD, FAAP carried the Olympic torch for children everywhere. Kids spend more time online than they do in school. Children’s Joanne Cox, MD reflects on the alleged Gloucester pregnancy pact on the eve of Lifetime’s movie based on news stories. Keep up with Children’s disaster response teams working in Haiti.

Other stories we’ve been reading:

We discovered this week that Thrive is listed as one of the top 50 early childhood health blogs! The FDA voices some concern over BPA risk. Using the term “concussion” versus “brain injury” garners different responses from parents.

Parents feel traumatic stress after their child’s been injured. Twenty percent of teens have unhealthy cholesterol. Researchers are asking why U.S. birth rates are falling.

Parents get to grade public schools. Children raised by same-sex couples do just as well as those raised by parents of both sexes. First Lady, Michelle Obama is launching a major initiative to fight childhood obesity.

Gloucester, a Massachusetts fishing town, made national headlines in the summer of 2008 when it was discovered that 17 teenage girls from the same high school were pregnant. This pregnancy pact hasn’t been confirmed by any of the teens, but that hasn’t stopped Lifetime from making a movie based upon these events. The movie, “The Pregnancy Pact,” is scheduled to premier Saturday, January 23.

Joanne Cox, MD, medical director of Children’s Primary Care Center and Young Parents Program, offers her views on the Gloucester event and how to prevent a new epidemic of teen pregnancy.

When I started my career as a pediatrician in the mid 1980s, teen pregnancy was rising dramatically. The consensus at the time was that our society sent mixed messages to teens about sex. The media projected highly sexualized images while communities often avoided discussions about sex.

From my present vantage point, having provided primary care to children and teens for the past 20 years, it’s clear that there have been dramatic advances in teen pregnancy prevention.  At the same time, the teen pregnancy event among Gloucester High School students are cause for concern, especially since Gloucester is not alone and we are seeing quite dramatic increases in teen births in other communities.

These increases need to be understood against the background that as a state and country we have made significant progress in reducing teen pregnancy and birth rates. From 1990-2005, the birth rate for 15-19 year olds in the U.S. declined 34% and Massachusetts has done even better, realizing a 42% reduction in teen pregnancy among females 15-19 years old.

But securing these gains and making continued progress is not assured.  You cannot “solve” the teen pregnancy problem once and for all.  It requires ongoing effort and investment to make sure every new generation is educated and has access to services.  As we have witnessed in Gloucester, many of the same underlying conflicts we saw 20 years ago remain between those emphasizing safe sex and those urging abstinence.  If we are going to prevent any backsliding of the gains we have made in reducing teen pregnancies, we need to transcend this dialectic.

Effective strategies for preventing teen pregnancy require both education and access to important health services.  Teens need to have information about sex and the consequences of pregnancy.  Abstinence promotion is an important element of comprehensive sexual education programs.  Teenage girls especially should be encouraged to plan for the future and understand the opportunity costs of becoming mothers at an early age.

Teens also need clear and unbiased information about contraception and the practice of safe sex. It is important to empower young women and men who may be sexually active to use contraception. There is no evidence that contraceptive education results in increased sexual activity.

Comprehensive school and community-based sex education is critical. But education alone will not suffice.  Community health centers are vital resources for teens, especially for those in underserved areas.

In areas where community health centers do not exist, family practitioners, pediatricians, and nurse practitioners must step into the gap. All teens need access to confidential risk assessment and counseling from their health care provider.  It is considered a normal part of growing up for a teen to start taking responsibility for some of their own health care.  The parents of my teen patients are most often appreciative when I ask them to step out for part of the visit, allowing me to provide information to my patients on pregnancy, sexually transmitted diseases and contraceptives.

The provision of contraceptives in school-based clinics is highly controversial, with the issue generating most of the debate in Gloucester, but studies strongly suggest that availability of contraceptives is crucial to preventing pregnancy in areas with otherwise poor health access for teens.

The bottom line is we have a common interest in preventing teen pregnancy. We need to embrace strategies aimed at delaying sexual activity as well as providing comprehensive and confidential health services for preventing and limiting teen pregnancy before it becomes epidemic again.

What do you think is the most effective way to avoid teen pregnancy?

This week the Kaiser Family Foundation released a report detailing just how much media kids are using.

What’s going on?
A new report from the Kaiser Family Foundation confirms that media are a constant presence in kids’ environments:

• Kids spend more time using media than they spend in school: Kids use TV, music, computers, video games, movies and print for a total of 7 hours and 38 minutes a day.
• Kids have media in their pockets and bedrooms: 66% of kids own a cell phone, 76% own an MP3 player, 71% have a TV in their bedroom, 50% have a gaming system in their bedroom.
• Kids are media multi-tasking: For more than 25% of the time kids spend using media, they are using two types of media at once (e.g. watching TV and chatting online)

Why should I care?

• Kids learn from what they see and hear. All media are educational. Some teach accurate, healthful lessons, while others teach misleading and harmful lessons.
• Kids need time for healthy activities. If media are constantly in use, kids may not have time for the activities that will keep them healthy: eating balanced meals with family, doing homework, being physically active, playing creatively, and, most importantly, sleeping.

What can I do?

• Create limits and rules around media. The Kaiser report found that kids whose parents had any kind of rules about media used 1/3 less media than those whose homes had no rules at all.
• Keep media in common areas. Keep dinner time TV-free, leave the computer in the family room and if you don’t have TV in your child’s bedroom yet, keep it that way.
• Teach active, critical media use. Engage kids in thinking about the media they use, rather than passively consuming it. These skills will stay with them, no matter how media change.
• Ask questions. If you have questions about media and kids, or want to see what other parents are asking, log on to Ask the Mediatrician.

Children’s Mediatrician and director of the Center on Media and Child Health, Michael Rich MD, MPH, was quoted in an article by The New York Times and interviewed on NBC Nightly News about the Kaiser Family Foundation report.

Visit msnbc.com for breaking news, world news, and news about the economy

Children’s research made the Huffington Post’s Top 10 Medical Research Trends to Watch in 2010. We find out exactly how dangerous secondhand smoke is to children. Are American destined to be obese? Two studies show how important a good night’s sleep for your children is. A gene for a devastating kidney disease is discovered. Do you know the dangers of leaving your child in the car alone? Dr. Rich responds to comments on his Call of Duty post. Have Americans finally hit an obesity plateau? The Flu Fighters invade Facebook. Children’s sends a team into Haiti and we offer advice on how to talk to your children about this devastating event.

Other stories we’ve been reading:

Are kids’ films getting better or worse about safety? New studies say that psychotherapy can help teen girls avoid obesity. Young hunters are more likely to incure treestand injuries.

You don’t need a large amount of lead to damage kids’ kidneys. Adult’s breathing troubles can start in childhood. There are more lung infections due to kids’ pneumonia vaccines.

One-fourth of all teen girls have been involved in violence. England wants to keep kids away from tanning beds. Breast feeding could lower your child’s risk of mental health problems.

H1N1 and seasonal influenza beware – new heroes have arrived, ready to defend the population and fight a viral battle, via Facebook, in the form of ‘Flu Fighters!’

Developed by researchers at Children’s Hospital Boston, in collaboration with the Department of Health and Human Services (HHS), a new Facebook application called “I’m a Flu Fighter!” gives you the opportunity to mobilize and take action against the threat of influenza – by telling your friends that you got the H1N1/seasonal flu vaccine and encouraging them to do the same. Launching as part of National Influenza Vaccination Week, the app also provides information on influenza – including a flu vaccine locator – courtesy of HHS’s Flu.gov.

The app is garnering high profile attention and was even plugged on the White House blog on Saturday by Secretary of Health and Human Services, Kathleen Sebelius.

The application is part of the HealthySocial project, founded two years ago by Ben Reis, PhD, of the Children’s Hospital Informatics Program (CHIP). CHIP has been instrumental in connecting the public with health care issues through technology. Reis and his team are working on a range of free social apps that allow users to collaborate with their friends to encourage better health.

“Social networks have tremendous potential to do good in the world,” says Reis. “By leveraging existing social connections, people can spread positive health behaviors and attitudes amongst their friends and loved ones.”

This isn’t the first social media tool that tracks flu to come out of CHIP. In September, they released a free iPhone app called “Outbreaks Near Me,” which tracks disease outbreaks in real time. The app got a lot of press coverage, including articles in the Wall Street Journal, Time, ABC News, USA Today and Scientific American.

Thank you for your energetic responses both in the comments section here on the Thrive blog and on Children’s Hospital Boston’s Facebook page to my recent post about Call of Duty and other violent video games; this is exactly the type of public dialogue that I was hoping for when I started my Ask the Mediatrician Web site last year. We all use media in different ways and have very personal opinions about the value it brings into our lives, but their use also impacts society as a whole, and my hope is for all of us to continue to question if we’re using them in a beneficial way.

Related to the some of the responses to the post that said I misrepresented some of the things that happen in the game, I acknowledge that, even though I play video games, I have neither the skills nor the practice time to be a great gamer, so Call of Duty: Modern Warfare 2 was demonstrated to me—I have not played it. I used the air terminal scene as an example of the game’s content, about which those of you with greater gaming experience have far more precise information and experience.

I apologize for any inaccuracies in my description of where certain events occur or how points are scored. These mistakes were not intentional and distracted from the goal of the post, which was to offer parents information about the effects that research has shown violent video games to have, and to encourage them to make their own decisions about how to parent their children using that information.

Setting aside the specifics of this particular game, it’s important to address what the research shows about violent video games in general. As individuals, we draw conclusions based on our experience, but health research is necessarily held to a higher standard—it must be based on observations of large groups of people. Therefore, physicians advise against smoking not because every individual who smokes gets cancer, but because smoking cigarettes increases your risk of getting cancer. Similarly, many research studies have shown (here, here and here) that the majority of violent video game players do not go out and start shooting people—but they do show that those who view violent movies or play violent video games experience a consistent, measurable shift in their attitudes and behaviors toward greater fear and anxiety (especially in children), desensitization to suffering, and, in some, increases in aggression.

The positive and negative effects of media on children deserve special attention because children’s brains are different than adults’ brains. For example, while children can say that an experience is “only make believe,” developmental psychology has demonstrated that until they are about 7 or 8, children’s brains have not developed to the point where they can reliably distinguish fantasy from reality. Even with older kids, the major concern is not that they will unthinkingly copy what they experience in violent media but that these media (like all media) will affect their expectations for normal human behavior. That means that experiences with violent media are more likely to contribute to everyday bullying than to the rare school shooting.

Video games, which present environments and conditions to which the player must respond in certain ways to do well, function as “behavioral scripts” which the player practices over and over. Interactive electronic media that immerse participants in a “virtual reality” are among the most effective teaching technologies we have. What children do, they will learn. Content matters. Therefore, as a pediatrician, I would steer parents and kids toward video games that are sports-, logic-, or strategy-based, instead of those that center on violence. And, as Steve said, in the end, it is parents themselves who know their kids best. They know what’s best for their family and we are offering them information with which they can make their own decisions.

It’s been great to hear from all of you. Let’s keep the conversation going!

A genetic discovery by researchers at Children’s and Brigham and Women’s Hospital brings new hope for a mysterious, devastating kidney disease called focal segmental glomerulosclerosis (FSGS). It’s the second leading cause of kidney failure in children and forces patients onto dialysis and, all too often, kidney transplant – only to recur in the transplanted kidney, sometimes within hours.

The research team, led by Elizabeth Brown, MD, of Children’s Division of Nephrology, performed a genetic linkage analysis in two large families with FSGS and identified a variety of mutations in a gene known as INF2. They then sequenced INF2 in 91 additional families. In all, they found INF2 mutations in 11 of 93 families, as reported online in Nature Genetics on December 20.

Other genes have been linked with FSGS, but Brown and colleagues think INF2 is an important find, as it seems to affect a larger number of families. The discovery may also shed some light on why the disease occurs.

INF2 encodes a protein that regulates actin, a protein vital to creating and maintaining the architecture of cells. Both actin and INF2 are abundant in podocytes, the kidney cells that are crucial in filtering toxins. The researchers thus believe the cause of FSGS may be disruption of podocytes’ structure and, therefore, function.

Right now treatments for FSGS are only guesses, because no one’s understood its underlying cause, says William Harmon, MD, chief of Children’s Division of Nephrology. Patients are mainly treated with steroids, which are only partially effective and have harsh side effects.

“FSGS is a frustrating disease for clinicians, as we have little understanding of the biology and poor treatment options,” says Brown. “We hope that further scientific work on INF2 will lead to better options.”

Read about how Children’s researchers investigate the genetics of congenital heart disease.

by Lawrence Rhein, MD, director of the Center for Healthy Infant Lung Development

Most people know that smoking is bad for the people who light up a cigarette and inhale. And most non-smokers know that inhaling someone else’s smoke can be unpleasant. But is it dangerous?

High in toxic chemicals, secondhand smoke causes or contributes to many health problems, including heart disease, cancer, and Sudden Infant Death Syndrome (SIDS). A new study, out this month, adds to the growing evidence that exposure to secondhand smoke is especially concerning for children. (more…)

Other stories we’ve been reading:

The FDA warned Nestle that its health claims on Juicy Juice are against the law. New iron fortified rice reduces anemia. Using kitchen spoons to measure medicine raises risk of dosing errors. Does folic acid during the late stages of pregnancy lead to children with asthma?

Showing kids how fast they eat may help them shape up. When it comes to teen weight-loss surgery, timing is everything. Tiny frogs are causing giant stomach aches in kids. What’s the best way to offer your kids vegetables at dinner?

Kids’ vaccines are making holiday visits less infectious. California has turned up 10 autism clusters in neighborhoods with high concentrations of white, highly educated parents. Abused children are much more likely to develop migraines as adults. When it comes to math skills, gender differences are hard to find.

Post update: Dr. Rich responded to the comments on this post, including whether he got some of the facts about the game wrong. Check out his response.

Media expert Michael Rich, MD, MPH, director of the Center on Media and Child Health at Children’s Hospital Boston, answers your questions about media use. Last week, he discussed junk food ads on kids’ websites.

Here’s this week’s question:

Can teenagers’ bedtimes be an indicator of whether or not they’re more likely to be depressed or suicidal? A recent study in the journal SLEEP suggests so. Children’s sleep specialist Dennis Rosen, MD, talks about why this study is an important indicator that teens should be getting a good night’s rest.

by Dennis Rosen, MD

The observation that most teenagers (roughly 80%, according to the National Sleep Foundation’s 2006 “Sleep in America” survey) get fewer than the recommended 9 hours of sleep a night is not new.  Nor, for that matter, is the connection between insufficient sleep and mood disorders, which has been borne out in sleep deprivation experiments in adults as well as in population studies in adults and teens.  Everyone needs to sleep, and despite not always wanting to tuck in and call it a day, teenagers are no different than anyone else in that respect, and suffer a whole host of negative consequences when they do not get enough sleep.

A new study published in the January 2010 issue of SLEEP looking at the effect of bedtimes set by parents on mood in 15,659 7-12^th graders found that the later a child’s bedtime was set, the more likely the child was to have symptoms of depression and/or thoughts about suicide.  Later bedtimes were also found to correlate with shorter sleep duration (not a big surprise) and a sense of not getting enough sleep, both as reported by the child.  Those children with earlier bedtimes were also more likely to describe their parents as caring more about them than those with later bedtimes. Overall, children whose bedtime was set at midnight or later were 24% more likely to suffer from depression, and 20% more likely to have suicidal thoughts than children whose bedtimes were 10 PM or earlier.

As with all studies of this type, questions of cause and effect arise: did the later bedtimes truly cause the increased depression, or did underlying depression lead to later bedtimes?  Sleep disturbances are one of the defining characteristics of depression.  It may be that in many instances, pre-existing depression influenced the hour at which bedtimes were set.  Lax limit setting on the part of parents, manifesting as unfettered bedtimes, could also have contributed to a sense in some that their parents didn’t care as much about them as they felt they should, which in turn may have led to symptoms of depression.

Still, the findings are intriguing, and worth paying attention to.  Despite many and frequent protests to the contrary, teenagers really do need a certain amount of sleep (about 9 hours/night). It is very important to realize that sleep is not something to be done when there is nothing better, or more exciting, left to do. Sleep is necessary for both good short term function and long term physical and mental health. Setting age appropriate bedtimes, while not always easy to enforce, is, ultimately, not all that different from setting limits on other activities which can adversely affect health, such as cigarette smoking.  As the findings of this study suggest, it is likely to be well worth the effort.

Read more of what Rosen has to say on children and their sleep on his blog, Sleeping Angels.

Do you set bedtimes for you children?

Rosen also wrote a blog about whether or not sleeping late can keep you slim.

By Mark Alexander, MD, associate in Cardiology

I was asked to write this post just before a 17-year-old hockey player died after a practice in Haverhill. While we don’t know exactly why this young man died, it’s indicative of a typical case of sudden cardiac arrest. He seemed healthy and vibrant and collapsed suddenly just after exercising.

In addition to the personal and community grief, this event focuses attention on the cardiac risks athletes (or any child) face, and whether more intensive screening can prevent these tragedies. The call for increased screening gained steam after the release of a recent study from Texas, in which high school athletes were screened with an electrocardiogram (ECG) using a specially designed laptop. Just under 10 percent were then referred for more formal testing, with 12 of the 2,100 disqualified from sports and another dozen identified as having potentially important cardiac conditions. The authors suggest that all athletes should be screened and that using the laptop technique the ECGs can be performed for a mere 50 cents.

So is wider – even mandatory – screening of athletes warranted?The answer is complicated, but the discussion shares themes that have been discussed in recent weeks related to breast cancer screening and how we organize health care. At the core of both issues is the question: How do you prevent a very low-risk but tragic event with tests that aren’t perfect?

1. Do we know what causes problems like this in young athletes?
   Fortunately, we have a very good sense of what causes sudden cardiac arrest in school-age children, and about half of at-risk children are identified early in childhood. Of those without a prior diagnosis, hypertrophic cardiomyopathy, Long QT syndrome and coronary problems lead the list of hidden life-long diseases, along with acute heart infections. Not all of those children will have symptoms prior to a cardiac arrest. Asthma and other non-cardiac diseases can also lead to sudden death.

2. Do organized athletics increase risk of cardiac arrest in children more than active play, dancing or other activities?
   Many cardiac events, at every age, occur during exercise. At the same time, exercise has enormous long-term benefits that over years may actually decrease risk of coronary disease, hypertension, obesity and other long-term adult problems. In children and teens, we think that if exercise increases risk, that increase is quite small. Even for hypertrophic cardiomyopathy, the most common disease identified in the death of young athletes, most cardiac arrest occurs at rest and in non-athletes.
3. Do stimulants used for ADHD cause cardiac arrest?
   There is little doubt that overdoses of those medications can be dangerous. There are suggestions that in rare cases, normal doses increase the risk of sudden cardiac arrest in children, but at the same time, they may decrease the risk of car accidents in teenage drivers with ADHD (which are very common).
4. Is there something unique about the teenage athlete that makes them appropriate for extra testing?
   The death of an athlete almost always produces headlines in the local papers that make those deaths seem more common. The families of the dancer, violinist or video-gamer are just as devastated at the loss of their child, but those families typical share their grief in private. In Massachusetts, up to 70 percent of high school students participate in at least one sport, so screening athletes really means not screening 30 percent of the students. It’s very difficult to create a moral context in which we elevate any group for special care.
5. Does the ECG find things?
   Absolutely. ECG screening identifies important diseases on a regular basis. In the older teen, it’s pretty good at making us suspect hypertrophic cardiomyopathy, though in the younger child it may not find anything. ECGs aren’t always right, of course. They can neither identify all the patients nor all the diseases.
6. Would it only cost 50 cents to screen athletes? And if so, should we do it?
   If it sounds too good to be true it probably is. The Texas study calculated costs using donated computers, ECGs done for free by the school trainer, read for free by the authors and probably dramatically under-estimates the costs of a careful consultation. Commercial ECG screening companies typically charge about $50 paid by the parent with a reasonably prompt report and further testing determined by the primary care physician. While ECGs alone are relatively inexpensive, careful consultation regarding abnormal findings can take several visits and be expensive.
7. Aren’t my child’s physical and the forms I need for sports screening tests?
   Absolutely. The questionnaires ask important questions, not just about cardiac disease, but asthma, concussions and orthopedic concerns. When families and physicians pay attention to these issues during annual physicals, the primary care doctor can help get appropriate referrals or additional testing. For those children who have an important cardiac symptom or family history an ECG is almost always part of the evaluation.
8. I’m still worried.
   As parents, we worry, that’s part of our job. As a parent of three college students and a cardiologist taking care of survivors of cardiac arrest, though, I worry more about car accidents, depression and suicide, alcohol and drug abuse (and how those relate to car accidents). We know that cardiac arrest probably happens in only two to four children per year in Massachusetts, compared to 70 deaths from car accidents and 21 from suicide.
9. What if a family member had a cardiac arrest or unexplained drowning?
   Families who have experienced unexplained sudden cardiac arrest should start with getting evaluation of  those closest (parents and siblings) to the family member who died. That may involve evaluating the parents and siblings. Autopsy is reasonable for excluding many diagnoses, but can’t find the 10 to 20 percent of those caused by Long QT.
10. So should we be getting ECGs on all children?
    I don’t think so, at least not yet. No test is perfect at preventing rare events. Making the decision to add ECG screening for athletes, or all children (70,000 students/grade in Massachusetts) is complicated. Most of the children we are trying to identify will either have symptoms or an important family history that already deserves investigation.

Also read a story we did a few years ago about this topic in Children’s Pediatric Views publication.

Media expert Michael Rich, MD, MPH, director of the Center on Media and Child Health at Children’s Hospital Boston, answers your questions about media use. Last week, he discussed the effect of movies on babies.

Here’s this week’s question:

Q: My 7-year-old son is extremely good at navigating the Internet. In fact, he’s taught me almost everything I know about using the Web. I have software that blocks him from everything except kid sites like PBS, Nickelodeon, Disney, and the Cartoon Network, where he has spent a lot of time and they seem harmless enough, but recently I’ve been hearing about junk food ads on websites. I don’t think he looks at them, but I’m wondering whether that’s a problem anyway. Am I missing something?
–Websurfing in Washington, DC

A: Dear Websurfing,

Your impulses with regard to the Internet are right on. The Internet is a place where your son can both learn a great deal and become very technologically skilled but it’s also possible and likely that he’ll be exposed to material that is not optimal for him. In an era when kids are digital natives and parents are digital immigrants, your question is extremely common.

The sites you’re allowing him to access probably won’t expose him to overt violence or sex, and that is a positive thing. But remember that pre-selecting sites isn’t enough to teach him to use media critically.  Like pretty much everything else on the Web, even kid-oriented sites exist to attract users, build brand loyalty, and/or attract money to their enterprises. For that reason, it is important that your son learn to think critically about all media, even those that seem harmless.

Just recently, researchers looked at the sites most used by kids, and they found that only 5 of the 77 advertised food products were things that kids should be encouraged to eat. The vast majority touted high-calorie, low-nutritional-value foods, such as candy, cookies, and sugared cereal. And even though your son may not be paying specific attention to those ads, there is evidence that people exposed to online advertising think favorably about advertised brands, even if they don’t remember seeing or paying attention to the advertising. Therefore, the advertising he is exposed to is likely to affect him whether he thinks it does or not.

To help reduce the effects of junk food advertising on your son, help him understand that he is being aggressively pursued as a consumer of products that aren’t best for him. Point out ads, and ask him questions about them, like what it’s for, who it’s for, and why the people who created the ad created it (e.g., to keep him healthy and happy?). Doing this will help him build the skills he needs to critically view and discard the messages he’s receiving from these junk food ads, and that can help him get the most benefit and least harm from his experience on the web.

Enjoy your media and use them wisely,
The Mediatrician

Do you have a question about your child’s media use? Ask it today!

Here’s a quick look at what Thrive was up to last week.

The Boston Globe Magazine quotes a Children’s psychologist in an article on how to raise kids with allergies. Do you know how to keep holiday ornaments from being hazardous to kids? The CDC recalled 800,000 children’s H1N1 vaccine doses. In our first Kids Giving Back to Kids post, we learn about children in medical research. Children’s nutrition specialist gives tips on healthy holiday eating. Claire McCarthy, MD emphasizes downtime for your kids this holiday season. Boston moves to ban texting while driving. Former Children’s patient, Glen Martin, is giving back to kids. WBZ-TV shares the story of a Children’s patient who is battling stage IV neuroblastoma. Children’s patient, Minnie, shares her story about how having Type 2 diabetes has changed her life.

Related posts:

1. This week on Thrive: Nov. 16 – 20
2. Boston moves to ban texting while driving
3. Texting and driving

Other stories we’ve been reading:

Uganda outlaws female circumcision. A new polio vaccine is going to be used in Afghanistan. Researchers have developed an artificial clotting agent to help stop massive bleeding.

Playground injuries aren’t about fall – it’s the landing. Fifty million shades have been recalled for strangulation risk. Pregnancy spacing matters in babies’ health and STDs are common among sexually active teen girls in cities.

The CDC has a healthy version of the song The 12 Days of Christmas. Watch NYC’s latest anti-soda ad.

Media expert Michael Rich, MD, MPH, director of the Center on Media and Child Health at Children’s Hospital Boston, answers your questions about media use. Last week, he discussed negative portrayals of black women in the movies.

Here’s this week’s question:

Q: There is a movie theatre near my home that has afternoon shows for moms, where they put out a changing table in the theater and don’t lower the lights all the way—but then they show very adult movies. What effect does being exposed to these movies have on infants and toddlers, most of whom are not talking yet?
–Skeptical about Screenings, Pacific Palisades, CA

A: Dear Skeptical,

This accommodation for moms certainly seems like a great convenience, but you are right to question its effects on the babies. Because the babies are not yet ready to talk — a stage called “pre-verbal” — it’s tempting to believe that they are not affected by what’s on screen. And it’s true that they probably can’t figure out the images in any meaningful way. So what’s the problem?

The main problem with this kind of arrangement is that babies are exquisitely attuned to their mothers’ feelings. Films geared toward adults often involve fear, violence, and/or sexuality, and if the films are any good, they are probably affecting the moms’ emotions.  Babies will feel those changes in emotions, and they can form associations between mom’s emotional response and whatever is in the environment at that moment. For example, if a dog barks during a scary scene and mom’s adrenalin increases, the child may end up with an almost intangible fear of dogs.

Research shows that anxiety and fear responses tend to be tied to single exposures; in other words, becoming scared of something can happen even if someone’s only seen it once. One study showed that some young adults who saw Jaws as children would not go into the water–not even swimming pools–even years later because they had such a deep fear of sharks.

These sorts of fears are easily formed in a baby’s brain, which creates 700 new synapses, or connections, per second. These synapses are created in response to whatever is going on around the baby. For that reason, parents should put their infants in environments that will build their brains the way they want them to be built. Movies made for adults are likely to have the opposite effect. When moms want to go to the movie theater, their best bet for helping to build their baby’s brain to be strong and healthy is to hire a sitter and head out for some well-deserved fun without their little one.

Enjoy your media and use them wisely,
The Mediatrician

Do you have a question about your child’s media use? Ask it today!