MCH Updates in Pediatrics Masthead  

                       Volume IV
                        Issue 30
                                                           South Florida's  only licensed  free-standing
                                                             specialty hospital  exclusively for children ...                                                      July 24,  2013 
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Smoking & Breast Milk Changes 

An interesting small study of 20 post-partum women who smoked during pregnancy and lactation (> 5 cigarettes/day) and whose breast milk was analyzed between 17-30 days after delivery for amount/type of fatty acids present, and compared to a similar non-smoking group, indicates that smokers' breast milk has significantly higher amounts/concentrations of fatty acids and mono and poly unsaturated fatty acids, with lower values of linoleic to arachidonic acid ratio.


Smoking during pregnancy and lactation has many deleterious effects. It appears that it also changes the fatty acid profile of human milk (no data available as the whether this is beneficial or deleterious - Ed.)


Acta Paediatrica

Apparent Diffusion Coefficient (ADC) on brain MRI, & abusive head trauma (AHT) outcomes

The water molecules in the brain cannot diffuse freely as many obstacles e.g. macro molecules, fibers, membranes, etc., interfere with their diffusion. This phenomenon allows for water molecule diffusion patterns on MRI to reveal microscopic details of tissue architecture and integrity. Apparent Diffusion Coefficient (ADC) values which take the above into account have been established to documented normal brain parenchyma.


A study of 14 AHT patients (range 1-18 months of age) whose ADC values were retrospectively reviewed and related to clinical outcomes, indicates that ADC values measured within 4 days post-admission strongly correlate with poorer long-term neurodevelopmental outcomes.


Acta Paediatrica 

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Physician knowledge of medical care costs    


A perspective trial assessing physician knowledge of provided care costs (involved Emergency Department patients, their Attending and Resident providing the care), indicates that physicians underestimate (by 36%) total charges 93% of the time, independent of seniority of the physician.


One facet of providing cost-effective medical care will be the appreciation by physicians of the costs involved when prescribing investigations and treatment (Ed.)


American Journal of Emergency Medicine 

Pacifier cleaning practices & risk of allergy      


A study of 184 infants examined at 18 and 36 months for clinical allergy and sensitization to airborne and food allergens whose pacifier were "cleaned" either by their parents sucking them, or by a different cleaning technique, indicates significant protection from eczema and asthma in those infants whose parents used their mouths to clean the pacifier. Parental salivary microbiota may stimulate infant immune responses and thereby reduce the risk of allergy development.


Video Feature 
How to Stop a Crying Baby : Pacifiers to Quiet Crying Babies
How to Stop a Crying Baby : Pacifiers to Quiet Crying Babies

ExpertVillage via YouTube

Fitness & Academic Achievement 


A FITNESSGRAM test battery (5 components of health related fitness) was utilized in 838 young boys and girls to examine the relationships between fitness and academic achievement (using a standardized achievement test) in middle school children. Children Running


Both boys and girls who are in the Health Fitness Zone for aerobic fitness or muscular endurance are approximately 2-4 times more likely to meet or exceed reading and math test standards.


Acta Paediatrica 

Malpractice Among USA Pediatricians 


A nationwide analysis (from 1991 to 2005) of 1,630 pediatricians and 40,916 total physicians, reveals that 3.1 % of pediatricians (compared to 7.4% of other physicians) face a malpractice claim yearly. 20.5% result in an indemnity payment of which 3.7% are over $1,000,000.00. Permanent injury result in larger payments than fatalities and mean time to resolution is 23.4 months (S.D. 21.8 months).



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