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This Month's Update
"Pediatric News Updates" are reported from actual news sources,
but do not necessarily reflect the opinions of Families United on the Net, www.thefunplace.com. For the well-being of all children, parents should not try to diagnose their children, but should seek the advice and care of a pediatrician or family physician.
VITAL STATISTICS POINT TO ENCOURAGING TRENDS
December, 1998 - Published Study from the Johns Hopkins School of Hygiene and Public Health in Baltimore, Md. and the National Center for Health Statistics, Center for Disease Control and Prevention (CDC) in Hyattsville, Md.
An all-time low national infant mortality rate and other continuing positive health trends for America's children have been reported.
Infant Mortality Rates
The U.S. infant mortality rates:
1997 - 7.1 deaths per 1,000 live births, representing 27,691 infant deaths.
1996 - Total of 28,237 deaths.
Maine had the lowest infant mortality rate in the U.S. in 1997 at 4.4 deaths per 1,000 live births. The District of Columbia had the highest rate at 14.1 deaths per 1,000 live births.
For the first time, this year's report includes information about fetal deaths, for which the latest available data is from 1996, showing a decline of 24.2 percent since 1980.
A higher percentage of pregnant woman sought prenatal care in the first trimester in 1997 (82.5 percent) than in the previous year (81.9 percent).
Compared to 1996, Hispanic mothers who received late or no prenatal care decreased from 6.7 percent to 6.2 percent. There was no change in this rate for white or black mothers.
Low-birth-weight birth rates were at the highest level reported since 1973, influenced largely by the significant increase in multiple births.
Based on preliminary data, 1,580,000 persons were added to the U.A. population in 1997 as a result of natural increase, the excess of births over deaths. The rate of natural increase was 5.9 per 1,000 population, unchanged from 1996, but down slightly from the 1995 rate of 6.0 per 1,000.
Life Expectancy and Cause of Death
Life expectancy at birth reached an all-time high of 76.5 years for all gender and race groups combined.
Death rates for children from all major causes declined.
Death rates for adults and children declined for heart disease, accidents, homicide, suicide, chronic liver disease and diabetes.
Mortality from HIV infection for adults and children declined by 47 percent.
Unintentional injuries remained the leading cause of death for children of all ages.
Among teens ages 15 to 19, homicide accounted for 18 percent of all deaths, a significant decrease from 1996, and suicide accounted for 13 percent of all deaths, a 2 percent decrease from 1996. Both homicide and suicide rates for this age group had been on the increase in recent years, but declined in 1997.
Deaths from motor vehicle traffic totaled nearly 7,500 and deaths from firearms totaled more than 4,000 among children ages 1 to 19.
MORE TEENS USING HEROIN THAN EVER BEFORE
December 1998 - Published study by Author Richard H. Schwartz, M.D., FAAP, referencing Substance Abuse Report (1997) and the National Institute on Drug Abuse (1997).
While the number of U.S. adolescents using heroin is still low, it is growing.
Teens who may be likely to use heroin are those whose school grades are falling and who also smoke cigarettes and commit antisocial acts for rebellion or for "fun". Heroin users, including teens, can look and act normal and attend school or hold down jobs. Their physical decline may be slow and subtle, and require a else look before it's too late.
- In 1988 the mean age of heroin use in the U.S. was 27. In 1995, the mean age of self=reported heroin use was 19.
- Use of heroin by American high school seniors increased 100 percent between 1990 and 1996 (from 0.9 percent to 1.8 percent).
- In 1997, the percentage of American high school seniors using heroin further increased, to 2.1 percent.
- Heroin is one of the most addictive narcotics. The reason for the increase in teen use is the purified heroin is not only widely available and less expensive than in the past, but also that it no longer requires injections. Teens snort or smoke the heroin, which they perceive as less dangerous than "shooting up".
- There are two different recent "mini-epidemics" of heroin use among suburban, middle-class teenagers in Texas and in Maryland, in which a number of teens were treated in emergency departments for heroin overdose.
NEW RECOMMENDATIONS ON ROTAVIRUS VACCINE
December 1998 - Vaccination Guidelines issued by the American Academy of Pediatrics (AAP).
The American Academy of Pediatrics (AAP) issued guidelines to its pediatric members for the use of a vaccine to protect children against rotavirus infection, a common winter infectious disease that results in diarrhea and low-grade fever. the action is in response to the August 31, 1998 U.S. Food an Drug Administrations (FDA) licensure of a rotavirus vaccine.
In order to prevent or decrease the severity of this infection, the rotavirus vaccination is given to infants at 2,4 and 6 months of age. The first dose of the rotavirus vaccination may be given as early as 6 weeks of age and as late as 6 months of age. However, each subsequent dose should be given at an interval of at least three weeks.
Virtually all children experience a rotavirus infection prior to school entry. The infection peaks during the winter in the United States and is responsible for an estimated 50,000 hospitalizations annually among infants and young children due primarily to dehydration from diarrhea, according to the Centers for Disease Control and Prevention (CDC).
REVISED GUIDELINES ON THE USE OF POLIO VACCINES
December 1998 - Vaccination Guidelines issued by the American Academy of Pediatrics (AAP).
The American Academy of Pediatrics (AAP) issued a statement to it's 55,000 member pediatricians offering new vaccine recommendation for the four dose immunization series to prevent polio in children. The AAP now recommends that most children in the United States receive the inactivated poliovirus vaccine (IPV), which is received as an injection at 2 and 4 months of age for the first two doses. Either the IPV or the oral poliovirus vaccine (OPV) is recommend for the third dose at 6 to 18 months and the fourth dose at 4 to 6 years.
The new recommendation also is aimed at reducing the are instance of vaccine-associated paralytic poliomyelitis (VAPP), which is associated with the live virus within OPV.
Some of the other recommendations of the AAP are as follows:
Parents should speak with their child's pediatrician about the advantages and disadvantages of each vaccine and the medical history of their child. The AAP continues to support the World Health Organization recommendation for the use of OPV to achieve global eradication of poliomyelitis, especially in countries with continued or recent circulation of wild-type poliovirus.
- OPV is acceptable when a parent refuses either IPV or the number of injections needed to administer the other recommended vaccines for infants.
- The IPV-only schedule is recommended for immunocompromised persons and their household contacts because OPV may pose possible side effects.
- An OPV schedule is acceptable in infants and children in whom routine immunization is not initiated until after 6 months of age.
- OPOV continues to be the vaccine of choice for control of outbreaks of the wild-type polio virus in the United States, and the AAP supports the need for federal resources to ensure that adequate supply of OPV for outbreak control.
CHILDREN WITH ADHD MORE LIKELY TO SUSTAIN SEVERE INJURIES
December 1998 - Children with attention deficit hyperactivity disorder (ADHD) are at a greater risk of sever injury than children without the condition, according to a recent published study. Researchers reviewed charts of children, from 5 to 14 years old, treated in pediatric trauma centers submitted by more than 70 institutions to the National Pediatric Trauma Registry between October 1988 and April 1996.
Children with ADHD were more likely to be boys, to be injured as pedestrians or on a bicycle, to inflict injury on themselves, to sustain multi-systems injuries, to be severely injured and to sustain head injuries.
Researchers stated that it is particularly important for caregivers to inform providers of medical care about the existence of the preexisting condition. ADHD is the most common childhood development disorder.
CHILDREN OUTGROW SPIT UP PROBLEM
December 1998 - Study published by Northwestern University and Children's Memorial Medical Center, Chicago.
Infants who spit up daily or have problems with spitting up at 6 to 13 months of age tend to outgrow the problem within a year, authors of a new study say. Regurgitation is common, it's important for physicians to understand the natural history of a child's spitting up (or regurgitation) habits) so that they can help parents monitor the condition for later mealtime difficulties.
The study found no increase in respiratory illness in young children with a history of spitting up, those with daily or problematic regurgitation were more likely to develop feeding problems. Feeding problems, like refusing to eat and mealtimes lasting more than one hour, were much more frequent after one year in the "spit-up" patients. While the authors believe it may be useful to screen infants with significant regurgitation for feeding problems, they noted that mealtime difficulties are common in all toddlers.
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