Safety When Swaddling: A guide for Parents

Parents should be aware that injuries, including deaths, have occurred with swaddling, including some incidents where no improper use of swaddling or unsafe sleep practice could be identified. An insecurely applied swaddle wrap or wearable blanket can unravel during sleep, and (as demonstrated by the infant deaths in a recent study by McDonnell and Moon), can end up obstructing the infant's airway or even strangling the infant. The plain truth is that the safety of these products, even when used as correctly as humanly possible, has not been established, and people who use them do so at their own risk.

Considering the resurging popularity of swaddling, parents need to ensure that they use swaddling as safely as we know how, within the context of a safe sleep environment. This includes the following:

• Learn about safe swaddling and the alternatives to swaddling (eg, standard infant sleepers/clothing of appropriate weight for the ambient temperature that can be worn without the need for additional wrapping).

• Ask health care professionals about appropriate layering and thermoregulation; some parents believe that infants need more layers than they really do. It would also be good practice to bring in what you plan to use at home for swaddling, and be tought how to swaddle properly to prevent damage to hips.

• Discuss with your health care professional when to discontinue swaddling. Although some physicians disagree about how long swaddling can safely continue, Dr. Rachel Moon, who is also lead author of the American Academy of Pediatrics Safe Sleep guidelines and chair of the Task Force on SIDS, believes that babies should not be swaddled past 2 months of age.

• If you are taking your infant to day care or a babysitter, you  need to ensure that these caregivers know how to swaddle properly (if swaddling is permitted at all) and follow all other rules of safe sleep. If you have stopped swaddling, caregivers should be instructed to stop swaddling as well.

• If you continue to use a wearable blanket or wrap beyond the recommended age (2 months), you must carefully watch for signs that the infant is close to being able to roll over, in either direction. You should observe the infant's movements during supine and prone play; an infant who seems close to rolling in either direction (a "partial roll") or who can roll from prone to supine should no longer be swaddled using any method. Even if the infant can't accomplish a roll by him- or herself, the movements that the infant makes in attempting to roll could unravel the swaddling wrap or blanket.

• Reinforce the other elements of the safe sleep environment.

The study by McDonnell and Moon illustrates a couple of very important points. First, it shows how very far we are from achieving the kind of consistent, safe sleep environments for infants that we hoped would exist by now in homes across the country, with or without swaddling. Second, it shows that swaddling has introduced another variable to this environment that poses risks for at least some infants, although we might not yet have a handle on who those infants are. Despite criticism from those who believe that swaddling is no riskier than hugging and singing lullabies, we have to treat swaddling with the caution that it has shown it deserves, as another element in the already overcrowded message about safe sleep that healthcare providers must repeat to all new parents before they leave the hospital and again at every well-baby visit.

More information on safe swaddling:
http://www.nct.org.uk/parenting/how-do-i-swaddle-my-baby

Read the full research findings here:
http://www.medscape.com/viewarticle/821892_1

Source:Medscape

The Brain Has It's Reasons

By Xavier Decup

Days are decreasing, as is the sunlight now that winter has come. During this time of the year, it is common to feel less happy, to feel less energy in our body and in our mind. The cold weather perturbs our health and we struggle to fight the tiredness and bugs. We start to have more soreness in different parts of the body. Sleep and other main functions of the body are affected. The usual explanation is the lack of sunlight during winter time affecs the level of serotonin. This molecule affects the mood and is one of the four main elements of the brain’s biochemistry.

What if the brain is the key? We usually forget that it is the mastermind of the body. The rest of the body is literally connected to the brain by the spinal cord. Everything starts from the brain and spreads through the nerves in the whole body. It is like a computer dealing with different software. The ability of this software to run depends on the heart of the computer. Having a good computer means having a high speed processor (the heart of the computer), that allows very fast exchange of information. Our body is the same. We need the brain to exchange information with the rest of the body in an easy and fast way in order to process the millions of functions. 

The brain is made of billions of neuron cells. They communicate with each other by electricity and chemicals called neurotransmitters. The four main chemicals in the brain are serotonin, dopamine, acetylcholine and GABA. The more balanced these chemicals are, the more the brain is able to maintain the health in the body. Unfortunately, stress, poor food and age are aggravating factors of unbalanced levels of neurotransmitters. Optimising the capacity and use of these chemicals is key for protecting our body from all these little disorders we suffer from in winter time. There are different ways to improve the function of the brain, such as medication, diet and supplements. 

The brain biochemistry defines the personality! 
Our natural dominant neurotransmitter is one of the components which make up our personality. The more our natural neurotransmitters are missing, the more our body struggles to fit with our way of life. Sometimes we can have a lack of other neurotransmitters (not the dominant one), that shows a different pattern of disorders. The treatment must be adequate to the symptoms and the personality. 

If you want to have a better idea of your nature, try the Dr Braverman Test (you can  find it on internet)

More Sleep for NICU Newborns

Sleeping like a baby is an oft-used cliche. But while sleep is crucial for sick and premature babies to grow and recover, it can be difficult in a bright, noisy hospital.

However those in a specially-designed ward in Bath can be confident of getting plenty of rest.

When we try to soothe a baby at home we keep the bedroom dark and quiet. Yet many sick babies are cared for in hospital wards that are neither particularly restful, dark nor quiet.

"There's not usually any controllable light in a hospital, it's very brightly lit and noisy - a technical environment," says Bernie Marden, a consultant neonatologist at the Royal United Hospital in Bath.

The new neonatal ward he runs has been designed with the needs of the families, babies and clinicians in mind - resulting in a fifth more sleep for the infants. A senor on the baby’s nappy recorded movement to determine how much each baby slept.

The nappy sensor

The parents appear to benefit also from the light and space in the new unit - the bar stools they used to sit on have been replaced with reclining comfortable chairs.

"I used to get called down to parents in a panic - as if they'd had 17 espresso coffees. Now they're less anxious and tense and I sometimes have to wake them up to talk to them."

Breastfeeding rates have gone up - in the new unit 90% of the babies go home breastfeeding, compared with 64% in the old unit.

Source: BBC News

New Research Directly Links Stress to Increased Headaches

Results of a new study may come as no surprise to headache sufferers: More stress means more headaches.

"The results add weight to the concept that stress can be a factor contributing to the onset of headache disorders, that it accelerates the progression to chronic headache, exacerbates headache episodes, and that the headache experience itself can serve as a stressor," Sara H. Schramm, MD, from University Hospital of University Duisburg-Essen in Germany, said in a statement.

"Our results underline the need for stress management strategies in people with headache, independent of the headache subtype," she added in comments to Medscape Medical News.

"Research suggests that mind/body treatments, including meditation, yoga or tai chi, and behavioral treatments such as stress management, coping skills, biofeedback and relaxation training may decrease headache frequency by 35% to 50%," Dr. Schramm noted.

The study team investigated the association between stress intensity and headache frequency in 5159 adults aged 21 to 71 years in the prospective, population-based German Headache Consortium Study.

Participants were screened quarterly from 2010 to 2012 about their stress levels and headaches using validated questionnaires. The researchers estimated the effects of stress intensity on headache frequency (days/month) for different headache subtypes, using a visual analogue scale from 0 to 100.

Tension-type headache (TTH) was reported by 31% of participants, migraine by 14%, and migraine combined with TTH by 11%. For 17%, the headache type was unclassifiable.

Those with TTH rated their stress at an average of 52 out of 100. For migraine, it was 62 out of 100; for migraine and TTH, 59.

For each type of headache, an increase in stress was associated with an increase in the number of headaches per month, the researchers found.

This indicates that Complementary Therapies, know for reducing stress levels, could be beneficial for all types of chronic headache sufferes. Cranial Osteopathy, Massage and Aromatherapy, all available at the clinic, could all be worth considering if you are suffering.


Source: Medscape

Warm it up with Winter Spice

By Bronwyn ward

It's miserable out there and with the weather comes colds, stuffy noses, lethargy and general grumpiness. So what can be done? Including more chillies into your diet can have benefits for all of these common winter problems. They improve circulation, ease sinus congestion, help you sleep better and encourage the release of your body's natural feel-good chemicals. Try this simple, healthy mid week meal to give you a boost, also makes brilliant lunchbox meals with some brown rice or in wrap breads and freezes well so give it a go!

My Mum's 'Refried' Bean Tacos 

Serves 2-4 (depending on greediness!)

1 Tin black beans (drained)
1 Tin kidney Beans (drained)
2-3 carrots, diced
1-2 red onions, diced
2-3 cloves garlic, crushed
1 fresh red chilli (hot or mild as you like)
1 dried whole chipottle chilli*
2 tsp cumin seeds
3 Cups water
1 Tbsp tomato paste
1 Tbsp tomato ketchup
1 Tsp red wine vinegar
Tabasco to taste
Seasoning to taste

To serve:
Taco shells
Diced fresh tomaotoes
Grated cheese
Gem lettuce
Greek yoghurt

In a large, heavy-based pot put the beans, carrots, onions, garlic, chillies, water and cumin seeds. Bring to the boil and then simmer with a lid half on for 20-30 minutes, add extra water if needed.
Add remaining ingredients and simmer for a further 10 minutes. The mixture should be fairly reduced and thick, add more water if sticking to the pot. Taste. If it's spicy enough, remove the chipottle chilli, if you like it hot, leave it in.  Blizz everything with a wand or food processor to a thick chunky consistency. Taste and season.

Serve in taco shells topped with tomatoes, cheese, lettuce, and maybe a little greek yoghurt to soothe younger palets.

*Found in the dried herbs section in most supermarkets. They have a wonderful smokey flavour and well worth getting. Great in soups, casseroles and all things tomato-ey!

Lavender Oil: Improves Sleep in Hospital Patients New Research Shows

By Bronwyn Ward

A recent study on the possible effects of pure Lanender oil on patients in hospital has shown that this oil may well be an effective way to improve sleep in an intermediate care environment.

Sleep deprivation in hospitalised patients is common and can have serious detrimental effects on recovery from illness. Lavender aromatherapy has improved sleep in a variety of clinical settings, but until now the effect has not been tested in the intermediate care unit.

The objective of the study was to determine the effect of inhalation of 100% lavender oil on patients' vital signs and perceived quality of sleep in an intermediate care unit.

A randomised controlled pilot study was conducted in 50 patients. Control patients received usual care. The treatment group had 3 mL of 100% pure lavender oil in a glass jar in place at the bedside from 10 PM until 6 AM. Vital signs were recorded at intervals throughout the night. At 6 AM all patients completed the Richard Campbell Sleep Questionnaire to assess quality of sleep.

The findings from the study were very interesting. Blood pressure was significantly lower between midnight and 4 AM in the treatment group than in the control group. The treatment group had a decrease in blood pressure and the control group had an increase; however, the difference between the 2 groups was not significant.  Mean overall sleep score was higher in the intervention group (48.25) than in the control group (40.10).

If this is the benefit for pateints in a hospital environment, imagine how helpful it may be for your own sleep issues or for family members. A few drops of neat lavender oil on a tissue and tucked into your pillowcase could provide a similar effect. It is safe to use with small children and babies but best to avoid direct contact with the skin.

source:medscape

Overweight in Kindergarten, Obese by Eighth Grade?

Children who were overweight when entering kindergarten in 1998 in the United States were 4 times as likely as their normal-weight classmates to become obese by age 14 years, according to an article published in the January 30 issue of theNew England Journal of Medicine.

Almost half (45.3%) of obesity cases that developed between kindergarten and eighth grade occurred among the 14.9% of children who were overweight when entering kindergarten in 1998. "The annual incidence of obesity during kindergarten among these children was 19.7%, as compared with 2.4% among children who entered kindergarten with normal weight," write Solveig A. Cunningham, PhD, from the Hubert Department of Global Health, Emory University, Atlanta, Georgia, and colleagues.

The authors analyzed data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999, a nationally representative database with information on 7738 children who entered kindergarten in 1998 and were followed-up through 2007.

The researchers estimated the annual incidence of obesity during the 9 years according to sex, socioeconomic status, race/ethnicity, birth weight, and kindergarten weight. They used Centers for Disease Control and Prevention thresholds to define obesity and overweight by body mass index quintile.

When the children entered kindergarten at a mean age of 5.6 years, 12.4% were obese and 14.9% were overweight. By eighth grade, at a mean age of 14.1 years, 20.8% were obese and 17.0% were overweight. Most of the occurrence of obesity, however, occurred in early grades, and the annual incidence of obesity declined from 5.4% during kindergarten to 1.7% between fifth and eight grades.

The researchers defined incidence as the occurrence of new cases of obesity in children not previously obese, as compared with prevalence, the proportion of all children in each age group who were obese. Understanding incidence "helps us identify the ages of vulnerability and to identify the groups at greater risk. It's a bit of [a] different perspective on how obesity affects us and on where we might want to focus," Dr. Cunningham told Medscape Medical News.

"Among the kids who would become obese by the time they were middle-schoolers, most of that happened early on in elementary school. That helps us focus on these early years of kindergarten, first, second, and third grade, when a lot of obesity may actually occur."

"Those kids who came to kindergarten already overweight had about 4 times greater risk of becoming obese during the subsequent years," Dr. Cunningham said. "That tells us that some component of the risk of obesity may be set in motion by the age of 5 already. Kids who were born large and overweight at entry to kindergarten were at the highest risk of obesity."

In an accompanying editorial, Steven L. Gortmaker, PhD, from the Harvard School of Public Health, and Elsie M. Taveras, MD, MPH, from Massachusetts General Hospital, both in Boston, write that the new study "adds clear evidence" to previous research that early excess weight is a key risk factor for obesity.

"Given the limited evidence for effective treatment of obesity among children under 6 years of age, the limited resources of most clinical settings, and the limited predictive value of the 95th percentile of [body mass index], severe obesity may be a more useful cutoff for referral to more intensive, multidisciplinary treatment," they write.

"[W]ide-reaching, cost-effective policy and programmatic changes aimed at improving nutrition and physical activity among broad populations of children are key if we are to reduce early childhood weight gain and the risk of incident obesity throughout childhood."

Source: Medscape

This research was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors and editorialists have disclosed no relevant financial relationships.