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

For Release: January 7, 2008, 12:01 am (ET)

BREASTFEEDING, NON-MILK FORMULA MAY DELAY OR PREVENT ATOPIC DISEASE

Atopic disease (atopic dermatitis, asthma, and/or food allergy) may be delayed or prevented in high-risk infants if they are breastfed for at least four months, or given certain hydrolyzed (hypoallergenic) formulas without cow milk protein. The revised AAP clinical report, “Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas,” states that the benefits of nutritional intervention are documented for high-risk infants – those with at least one parent or sibling with atopic disease. Current evidence is insufficient to document a significant protective effect of maternal dietary restrictions during pregnancy or lactation. Nor is there sufficient evidence that any dietary intervention after 4-6 months of age prevents allergic disease. This includes delaying the introduction of complementary foods.

EARLY EXPOSURE TO MOVIE SMOKING IMAGES STRONG PREDICTOR OF ADOLESCENT TOBACCO USE

The likelihood that an adolescent will initiate cigarette smoking may be influenced by movie smoking exposure occurring early in childhood. In “Longitudinal Study of Viewing Smoking in Movies and Initiation of Smoking by Children,” researchers at Dartmouth Medical School interviewed children, ages 9 to 12, from 26 schools in New Hampshire and Vermont on what movies they had seen. Results from the baseline interview showed that each child already had seen an average of 37 out of 50 popular movies they were asked about, exposing them to an average of 150 smoking occurrences. About 80 percent of the children’s exposure was due to smoking images portrayed in youth-rated movies. Follow-up surveys assessing new exposure to movie smoking and smoking initiation were then administered to the children at two subsequent one-year intervals. By the second follow-up survey, 9.6 percent of the children had initiated smoking. The results indicated that the baseline measure of movie smoking exposure was as important as exposure measured at follow-up in predicting children’s smoking initiation, suggesting that the process which leads children to initiate smoking begins much earlier than adolescence. Overall, movie smoking may contribute to future tobacco use in at least one-third of elementary school-age children.

EDITOR’S NOTE: In a related study, “Exposure to Smoking in Internationally Distributed American Movies and Youth Smoking in Germany: A Cross-cultural Cohort Study,” researchers found that smoking in internationally distributed U.S. movies predicted the likelihood that German adolescents would try smoking. The results mirror similar studies linking smoking in movies with U.S. adolescent tobacco use.

‘HUGGY-PUPPY’ INTERVENTIONS EASE CHILD WAR-RELATED STRESS

Intervention that included a “Huggy-Puppy” doll successfully eased the stress and improved outcomes for young children in Israel exposed to violence during the second Israeli-Lebanon war in 2006. In “Young Children’s Reactions to War-Related Stress: A Survey and Assessment of an Innovative Intervention,” researchers studied the effects of war exposure on 74 children, ages 2 to 7. Of these children, 35 received a brief intervention, during which each child was given a dog doll and encouraged to care for it. While most of the children had severe stress reactions to their war-related experiences, the children who were given a Huggy-Puppy doll experienced significant stress reduction. The more attached the child was to the dog, the better the outcome. A second, larger study assessed the effectiveness of a Huggy-Puppy intervention on 191 out of 292 children with war-related stress, with similar results. The study authors suggest that the “Huggy-Puppy” approach is a promising, cost-effective intervention for pediatricians and child health care professionals to help traumatized children.

PEDIATRICIANS PLAY CRITICAL ROLE IN OVERSEEING NEWBORN SCREENING PROCESS

In providing a medical home for patients and families, primary care pediatricians should oversee the newborn screening process to ensure prompt, optimal care. Advances in newborn screening technology, combined with improved diagnostic and treatment methods, have resulted in tremendous improvements in the health of lives of children and families. The AAP clinical report “Newborn Screening Expands: Recommendations for Pediatricians and Medical Homes – Implications for the System,” recommends that primary care pediatricians familiarize themselves with their state newborn screening program, and develop office policies and procedures to ensure that newborn screening is conducted and results are transmitted to them in a timely fashion. In addition, collaboration with local, state and national partners is essential for promoting policies to ensure universal newborn screening, and benefits of early intervention.

EDITOR’S NOTE: In a related study, “Quality Medical Homes: Meeting Children’s Needs for Therapeutic and Supportive Services,” researchers found that children with special health care needs who did not have a quality medical home, were less likely to receive appropriate therapeutic or supportive services.

CONTROLLED INFANT FEEDING LOWERS CHILD WEIGHT AT AGE 2

Parental restrictions on how much a child ate at age 1 typically resulted in lower weight at age 2. In “Controlling Feeding Practices: Cause or Consequence of Early Child Weight?” 62 mothers completed Child Feeding Questionnaires, assessing maternal pressure, restrictions and monitoring of a child’s eating habits, at age 1. Both maternal pressure to eat and food restriction resulted in lower weight at age 2 relative to the rest of the sample. These findings contradict previous studies which have linked food restriction with heavier child weight in older children and may be because mothers are relatively able to control the food environment of infants. However, the negative impact of restriction on children’s development of food preferences and self regulation of food intake may manifest later in development. The study authors recommend additional research to definitely determine the long-term link between feeding practices and weight in children.

ETHICAL STANDARDS NEEDED FOR ADOLESCENT RESEARCH ON SOCIAL NETWORKING SITES

With more than 55 percent of U.S. teens, ages 12 to 17, using online social networking sites to provide personal information on everything from friends to hobbies and favorite movies, the Internet may become the fastest, easiest way to conduct adolescent research. In the special article, “Research Ethics in the MySpace Era,” the authors argue that an ethical framework is needed to ensure adolescent privacy and confidentiality. While social networking site information is public, and the adolescents who create personal profiles need to clearly understand this, researchers should not personally identify or link potentially damaging information to specific adolescents. If possible, researchers should require adolescent, and in some instances parental, consent for participation in research projects. Researchers should not, however, be expected to join, nor seek consent from, individual social networking groups to gather data.

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.