Below are news releases and briefs on statements appearing in the August issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

For Release: August 6, 2007, 12:01 am (ET)

HAVING A PET PIG MAY OFFER SOME BENEFITS

Contact with farm environments in infancy might decrease the risk of juvenile Crohn's disease and ulcerative colitis. That's according to a study conducted in Germany entitled, "Contact With Farm Animals in Early Life and Juvenile Inflammatory Bowel Disease: A Case-Control Study." Parents of children (ages 6 to 18) from 13 hospitals received a questionnaire regarding consumption of raw milk, contact with farm animals or pets, age of contact, and presence of respiratory allergies. Of those surveyed, 444 had Crohn's disease (CD), 304 had ulcerative colitis (UC), and 1,481 were control subjects. The control group
consisted of children who did not have either of those conditions and were in the hospital undergoing a common eye procedure. Results showed that children with CD and UC were more likely to live in urban areas than were the control children, and the odds of regular contact with any farm animal during the first year of life were reduced significantly for children with CD or UC. The study also found that children with CD had an increased risk of respiratory allergies. The authors ascertain the hypothesis that contact with farm animals during infancy helps protect individuals against childhood allergies, might also hold true for protection against irritable bowel syndrome.

WHEN IS THE RIGHT TIME TO LEAVE THE HOSPITAL AFTER GIVING BIRTH?

Since there is no "one size fits all" answer to readiness for discharge after delivering a baby, the "Life Around Newborn Discharge" (LAND) study is the first ever to examine the decision-making of over 4,000 mothers and their pediatricians, and obstetricians about postpartum discharge and to identify which factors most related with mother-infant pairs readiness to leave the hospital. The significant factors associated with unreadiness included mother's race, history of chronic disease, inadequate prenatal care, delivering during nonroutine hours, newborn having problems in the hospital, being a first-time mom, intent to breastfeed, and if she received only limited in-hospital education. The study results suggest that the mother and the clinicians caring for her and her infant must make the postpartum discharge decision together, as perceptions of readiness at the time of discharge often differ. In
addition, clinicians should pay close attention to specific characteristics about the mother (for example, whether or not she is a
first-time mother and whether or not she is breastfeeding) and should emphasize in-hospital education in order to personalize discharge plans and maximize chances for a positive experience at home.

STRESS FRACTURE RISK IN ACTIVE ADOLESCENT GIRLS MAY BE HEREDITARY

*Please note: This following study was early released on Pediatrics online, so it is not embargoed.

For active teen girls and young women, heredity may be more important than the type of sports or exercise they engage in as a risk factor for stress fractures, according to the study, "Family History Predicts Stress Fracture in Active Female Adolescents." Stress fractures are bone defects resulting from repeated application of normal forces. They are especially of concern in active teen girls and young women, as they can indicate bone insufficiency. In active adult women, activity type and menstrual irregularities have been shown to be risk factors for such fractures. But in the 13- to 22-year-olds studied, all of whom regularly
participated in impact-loading sports or exercise in the six months preceding their stress fracture, family history alone stood out as a risk factor. The authors suggest that further evaluation of bone density is warranted in active female adolescents with stress fractures. However, they also emphasize that impact-loading exercise is beneficial for adolescent girls and should be promoted.

LANGUAGE BARRIERS PUT PATIENTS AT RISK FOR WRONG PRESCRIPTIONS

Nearly 52 million Americans speak a non-English language at home, and 23 million Americans have limited English proficiency (LEP). Language barriers can result in adverse consequences in health care, but little is known about whether pharmacies provide sufficient care to patients with LEP. In the study, "Language Barriers to Prescriptions for Patients With Limited English Proficiency: A Survey of Pharmacies," 175 Milwaukee pharmacies were evaluated on their ability to provide non-English prescription labels, information packets, and verbal communication skills. Results found that almost half of the pharmacists
were dissatisfied with their pharmacy's communication with patients who have LEP, and 11 percent rely on patients' family or friends for interpretation. About half of the pharmacies never/sometimes can provide non-English language (NEL) prescription labels or information packets, and about two-thirds never/ sometimes can orally communicate in NELs. Suggestions for improving patient communication included hiring bilingual staff or using telephone interpreter services when in-person interpreters are unavailable.

HOME SAFETY PRODUCTS COMMONLY MISUSED IN INNER CITY HOUSING

*Please note: This following study was early released on Pediatrics online, so it is not embargoed.

More than 90 percent of injury deaths in infants and toddlers occurred in the home, according to data from the National Vital Statistics System (1985-1997). Many residential injuries can be prevented using home safety products such as smoke alarms, stair gates, and cabinet locks. According to a study conducted among low-income families in Baltimore entitled "Home Safety in Inner Cities: Prevalence and Feasibility of Home Safety-Product Use in Inner-City Housing," mothers reported a higher use of home safety practices than observed by investigators. Although 98 percent of families reported having a working smoke alarm,
home observations found over 55 percent of those alarms to be non-working. In addition, 71 percent of families reported storing
medication in a locked cabinet, when home observation found that just 17 percent had locked medicine cabinets. The authors assert that the structural design of urban homes may be a significant barrier to home safety product use, and that researchers, manufacturers and legislators need to address injury-prevention issues unique to urban, low-income families. It is important for primary care physicians to ask if their safety recommendations are feasible in their patients' homes, and for parents to notify physicians and manufacturers if safety supplies are unable to be used because of the design or condition of their homes.

CAN IRON DEFICIENCY CAUSE ATTENTION AND RECOGNITION DEFICITS?

Iron-deficiency anemia (IDA) affects approximately 1 to 2 billion people worldwide, primarily women and children. Although the prevalence of IDA has noticeably declined in U.S. infants, low-income, minority, and immigrant infants and toddlers remain at increased risk. In the study, "An Event-Related Potential Study of Attention and Recognition Memory in Infants With Iron-Deficiency Anemia," researchers studied 15 infants with IDA and 19 infants who were iron sufficient. Both groups were tested on their ability to differentiate their mother's face from a stranger's face. The iron-sufficient infants showed greater attention and recognition responses to the mother at 9 months of age, but the infants with IDA did not show this pattern until 12 months,
suggesting a delay in cognitive development. The authors say additional studies are needed to assess the degree to which the delay in cognitive development seen in infants with IDA may affect their long-term development.

PEDIATRIC SCREENING QUESTIONNAIRE HELPS IDENTIFY DEVELOPMENTAL DELAYS

Developmental and behavioral problems are estimated to affect 12 to 16 percent of children in the United States. Since well-child visits are typically scheduled for 15 to 30 minutes - an insufficient time for assessment of all areas of development in addition to administration of vaccines and discussion of other age-related topics - it's not surprising that pediatricians fail to identify up to 80 percent of children with developmental delays in a timely manner. In the study, "Impact of Implementing Developmental Screening at 12 and 24 Months in a Pediatric Practice," a group of 1,428 caregivers and children attending their 12 or 24-month well-child visits between April 2005 and March 2006 completed the ASQ, a child development screening questionnaire. Parents answered questions relating to five areas of development: communication, problem-solving, gross and fine motor skills, and personal-social skills. As a result, referral rates for continued evaluation increased by 224 percent. The questionnaire was found to be beneficial, as 36 percent of the referred patients qualified for special education services, while 41 percent continued with closer
observation.

AAP ENDORSES NEW AHA RECOMMENDATIONS FOR PREVENTION OF NONINHERETED CONGENITAL CARDIOVASCULAR DEFECTS

While there have been major breakthroughs in understanding inherited causes of congenital cardiovascular defects (CCVD), little information has been available on noninherited factors that may have an adverse effect on fetal heart development. Results of a comprehensive literature review by the American Heart Association Council on Cardiovascular Disease in the Young identified a number of important lifestyle changes for mothers that may increase the likelihood that their child is born with a healthy heart

1. Take a folic acid supplement prior to and after becoming
   pregnant.
2. Discuss your medical history with your doctor and any
   medications you're taking, even over-the-counter medications.
3. Avoid ill contacts while in early stages of pregnancy,
   especially people with fevers.

This statement is endorsed by the American Academy of Pediatrics.

CDC Urges Parents to Protect Preteens with Three Recommended Vaccines

The following is a news release is for a Centers for Disease Control and Prevention (CDC) campaign in which the American Academy of Pediatrics (AAP) is a partner. It is embargoed until August, 1, at 12:01 am ET.

New CDC campaign launched during National Immunization Awareness Month encourages a routine health checkup for 11-and 12-year-olds.

As children approach their teen years, parents often worry about how to protect them from new risks and potential dangers. Experts at the Centers for Disease Control and Prevention (CDC) today launched a campaign to educate parents about one of the things they can do to protect their children at 11 and 12 years of age and for years to come: make sure they are vaccinated against serious, sometimes life-threatening diseases such as meningitis, tetanus, diphtheria, whooping cough, and cervical cancer.

The CDC's Preteen Vaccine campaign is designed to inform parents, caregivers, family physicians and pediatricians about CDC's new vaccination recommendations for 11- and 12-year-olds. The three preteen vaccines include MCV4, which protects against meningitis and its complications; Tdap, which is a booster against tetanus, diphtheria, and pertussis or "whooping cough," and for girls, the human papilloma virus (HPV) vaccine, which protects against the most common types of cervical cancer.

The campaign's launch coincides with National Immunization Awareness Month in August.

A new Web site, http://www.cdc.gov/vaccines/preteen/ provides easy-to-understand, downloadable educational materials in English and Spanish for parents and health care providers about the vaccines and the diseases they prevent.

"Many parents do not realize that some childhood vaccines, such as those for tetanus and whooping cough, wear off over time and, as they get older, young people are at risk of exposure to different diseases at school, camp or in other new situations," said Dr. Anne Schuchat, Director of CDC's National Center for Immunization and Respiratory Diseases.

Research shows that preteens generally do not get preventive healthcare, visiting the doctor only when they are sick. One goal of
this campaign is to encourage parents to take their preteens in for the recommended 11 or 12 year old check-up, which is endorsed by the American Academy for Pediatrics, and the American Academy of Family Physicians in addition to CDC. "The preteen check-up is a great time to talk with your child's healthcare provider about your child's development, nutrition, safety, and vaccination status," said Dr. Schuchat.

Dr. Renee Jenkins, President-Elect of the American Academy of Pediatrics, which is a partner with CDC in the campaign, stressed how important it is that parents take time to schedule a routine checkup for their 11 and 12 year olds.

"The preteen checkup is an important time to make sure children are also caught up on important childhood immunizations such as chickenpox, hepatitis B and measles-mumps-rubella (MMR)," said Dr. Jenkins. "Depending on their health and medical history, some preteens may require additional vaccines."

The campaign also seeks to provide caregivers and their health care providers with the latest information about preteen vaccines and the preteen check-up in the form of fact sheets and posters. It also includes outreach to mainstream and ethnic media, as well as the creation of partnerships with national and state organizations who reach parents, and healthcare providers.

CDC's preteen vaccine recommendations are supported by the American Academy of Pediatrics, the American Academy of Family Physicians, and the Society for Adolescent Medicine.

For more information about preteen vaccines, and the campaign, visit
http://www.cdc.gov/vaccines/preteen/

Facts about Pertussis, Meningitis and HPV/Cervical Cancer:

Pertussis, or whooping cough, is one of the most common respiratory diseases in American teens. It causes a prolonged cough that can last weeks or months and can result in pneumonia or hospitalization. Reported pertussis cases in the United States are on the rise - there were more than 25,000 cases in 2005.

Meningococcal infections can be very serious, and can lead to meningitis and even death. These infections are not very common - an estimated 1,400 to 2,800 cases occur in the United States annually. However, about 10 percent of teens who get meningitis die from it, and another 15 percent have long-term disability.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with about 20 million people currently infected. Women have an 80 percent chance of getting HPV by the time they are 50. Every year in the U.S., about 6.2 million people get a new HPV infection. HPV is most common in young people who are in their late teens and early twenties. In 2007, about 11,000 women in the United States will be diagnosed with cervical cancer, and about 3,600 women
will die from the disease.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.