Category Archives: Pediatric care
Preterm babies are born at a higher rate in the US than in 130 other countries, including many poorer nations, according to a report released today, Born Too Soon: The Global Action Report on Preterm Birth, published by the March of Dimes and almost fifty other groups, including the World Health Organization.
Preterm birth (birth before 37 weeks completed gestation) is the leading cause of newborn death in the US—nearly half a million US babies are born too early each year. Babies who survive an early birth often have breathing problems, cerebral palsy, intellectual disabilities, and other lifelong problems. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants, and the costs exceed $26 billion each year. “While our country excels in helping preemies survive, we have failed to do enough to prevent preterm births and help more mothers carry their babies full-term," says Jennifer L. Howse, president of the March of Dimes.
The report also highlights health disparities for newborns in the US. The rate of preterm births for African American mothers is 18 percent; the rate for white mothers is 11 percent.
Worldwide, the new report finds that 15 million babies are born preterm each year, and more than one million die due to preterm complications. Of these babies, the report notes, three-quarters could be saved if current cost-effective interventions were made more widely available. Those interventions, according to Dr. Howse, include:
- Giving all women of childbearing age in the U.S. access to health care, including adolescents, and including care before, between, and during pregnancy
- Behavioral changes to reduce the risk of an early birth, such as not smoking during pregnancy
- Progesterone treatments for women who have had a previous preterm birth
- Better management of fertility treatments that result in multiple births
- Hospital quality improvement initiatives to reduce early inductions and Cesarean deliveries before a full 39 weeks of pregnancy unless medically necessary
“This report underscores the need for action to reduce premature birth in the U.S., and state and territorial health officials have a critical role in championing and implementing proven solutions,” says David L. Lakey, M.D., president of the Association of State and Territorial Health Officials and Commissioner of the Texas Department of State Health Services. “Interventions that promote full term, 39-week pregnancies and improve the health of babies can significantly reduce health care costs.” Reducing preterm births is Dr. Lakey’s Presidential Challenge during his term as ASTHO president.
In February, the Department of Health and Human Services announced “Strong Start," an initiative that includes funding for enhanced prenatal care and hospital quality improvement programs. And the March of Dimes has launched its “Healthy Babies Are Worth the Wait” campaign to let women know that if their pregnancy is healthy, it’s best to wait for labor to begin on its own rather than scheduling a delivery. Elizabeth Mason, MD, director of the Department of Maternal, Newborn, Child and Adolescent Health for the WHO says model practices in other countries that have reduced preterm births include creating medical homes for expectant mothers, reducing hospital infection rates and both prenatal care and care throughout a pregnancy to monitor for concerns.
Christopher Howson, PHD, Vice President for Global Programs at the March of Dimes Birth Defects Foundation, says the current worldwide rate of preterm births could be halved by 2025 if the recommended interventions are carried out. “That is eminently, eminently feasible,” says Howson.
Bonus Reading: For a state-by-state breakdown of preterm birth rates within the U.S., see the March of Dimes 2011 Premature Birth Report Card online at marchofdimes.com/prematurity.
The National Highway Traffic Safety Administration has launched a new website, Parents Central, that will, quite frankly, help save children’s lives. The site offers frequently updated safety information for kids in cars—from the newborn firstborn to the teen homecoming queen—as well as safety guidance for travel of all kinds including bicycling, walking and riding the bus to school.
Last month’s Vital Signs report from the Centers for Disease Control and Prevention provides a critical evidence base for parents, and health care professionals, to book mark and follow Parents Central. The April report showed that child injury death rates dropped nearly 30 percent from 2000 to 2009, with a significant part of that decline coming from a 41 percent drop in motor vehicle crash deaths in children over the past decade. Safety measures that have reduced deaths in car crashes include use of child safety seats and booster seats, and more widespread adoption and the strengthening of graduated driver's licensing systems for teenagers.
While you’re on the Parents Central site, NHTSA resources well worth the look include guidance on choosing and installing car seats, the agency’s new campaign to prevent child heatstroke deaths in cars, and tips for staying safe when transporting kids in multi-passenger vans—especially as summer camps and trips start up.
Bonus Reading: Read about Operation Hang Up, an initiative in New York State this past weekend that had police officers aggressively ticketing drivers on their cell phones.
This week is National Infant Immunization Week, an annual observance to promote vaccinations in kids two and younger.
Last September the Centers for Disease Control and Prevention announced that childhood immunization rates for vaccines routinely recommended for children are at near-record or record highs. But CDC experts say that without ongoing efforts to maintain immunization programs in the US – and to strengthen them worldwide -- vaccine-preventable diseases remain a threat to children. In 2010, for example, an outbreak of pertussis (whooping cough) killed ten infants in California.
CDC and the CDC Foundation are recognizing innovative child immunization efforts this year with the CDC Childhood Immunization Champion Awards, a new annual award to recognize individuals who make significant contributions toward improving public health through their work in childhood immunization.
Innovations recognized this year include:
- A contest to help increase the number of people vaccinated against season flu.
- A link between a hospital’s electronic medical records and the state immunization registry which lets pediatrics practices upload vaccine information directly into the registry and gives providers easy access to registry data about their patients.
- Vaccine mobiles, providing free vaccines regardless of insurance coverage, parked at public spaces and linked to a state registry system.
Weigh In: What innovative approaches have increased infant immunization rates in your community?
Next week, young farm-workers from across the country will share their stories with officials and advocates in Washington, D.C., to discuss the challenges they face working in the fields from a very young age. The youth-led and youth-organized conference will also highlight communities that are working to empower farm-worker youth to achieve healthier lives. The topics of the conference were chosen by the participating youth as the most important issues in their lives:
- Health – Pesticide exposure, the effects of working in extreme weather conditions, safety issues in work with heavy machinery, the toll the job takes on one’s body, and drugs and alcohol as coping mechanisms
- Work in the Fields – Wages, sexual assault in the fields and health issues that result from being in the fields
- Housing – The stress of migrating during the harvest, and the problems unaccompanied youth face when migrating
- Education – Barriers that migrant farm-worker youth face in finishing school, programs in place to help many farm-worker youth reach their educational goals
The event, hosted and organized by the Association of Farmworker Opportunity Programs, will take place on April 26 to April 27. Learn more about and register for the event. Registration is now free, and anyone interested in attending can email email@example.com.
The holidays are an exciting and warm time of year -- but they can also pose some unique dangers. To help ensure you have a safe holiday season, here are some tips from the American Academy of Pediatrics (AAP).
- When setting up a tree at home, place it away from fireplaces, radiators or portable heaters, and out of the way.
- Cut a few inches off the trunk of your tree to expose the fresh wood. This allows for better water absorption and will help keep your tree from drying out and becoming a fire hazard.
- Be sure to keep the stand filled with water; heated rooms can dry live trees out rapidly.
- Check all tree lights--even if you've just purchased them--before hanging them on the tree. Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections. Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights, and a person touching a branch could be electrocuted. Before using lights outdoors, check labels to be sure they have been certified for outdoor use. To hold lights in place, string them through hooks or insulated staples, not nails or tacks. Never pull or tug lights to remove them. Plug all outdoor electric decorations into circuits with ground fault circuit interrupters to avoid potential shocks.
- Turn off all lights when you go to bed or leave the house. The lights could short out and start a fire.
- Use only non-combustible or flame-resistant materials to trim a tree. Choose tinsel or artificial icicles of plastic or nonleaded metals.
- Never use lighted candles on a tree or near other evergreens. Always use non-flammable holders, and place candles where they will not be knocked over.
- In homes with small children, take special care to avoid decorations that are sharp or breakable. Keep trimmings with small removable parts out of the reach of children to prevent them from swallowing or inhaling small pieces.
- Avoid trimmings that resemble candy or food that may tempt a young child to eat them.
- To prevent both burns and electrical shocks, don’t give children under age 10 a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
- Children under age three can choke on small parts contained in toys or games. Government regulations specify that toys for children under age three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long.
- Children can have serious stomach and intestinal problems – including death -- after swallowing button batteries and magnets. Keep them away from young children and call your health care provider immediately if your child swallows one.
- Remove strings and ribbons from toys before giving them to young children.
- Watch for pull toys with strings that are more than 12 inches in length. They could be a strangulation hazard for babies.
- Remove all wrapping papers, bags, paper, ribbons and bows from tree and fireplace areas after gifts are opened. These items can pose suffocation and choking hazards to a small child or can cause a fire if they come near a flame.
Bonus Tip: Clean up immediately after a holiday party. A toddler could wake up early and choke on leftover food or come in contact with alcohol or tobacco.
Read More Safety Tips from the American Academy of Pediatrics here.