Introduction

Welcome, I am Dr. Paul Smolen, also known as Doc Smo and this is Portable Practical Pediatrics. Every once in a while I like to give my listeners a glimpse of what is new in pediatric research that can translate into practical knowledge.  I’m not talking about new high tech treatments for exotic diseases but rather new information that most parents can use in their everyday parenting. So here goes with a conversation about four, high quality, peer reviewed articles that I think you will find interesting. Stay engaged, stay informed, and of course, stay tuned.  Today’s pedcast is brought to you by audible, the new way to digest books. For me, Audible has become my preferred method of exploring books, whether I am cutting the grass or driving in the car. Expand your world today by subscribing to audible. Just hit the link that accompanies this podcast to get started.

Musical Introduction

Article #1– Every year, most parents are put in the position of deciding if their Children should get a flu shot or not. Is that flu shot important for your kids?  Is it worth all the effort, hassle, and expense to arrange for them to get vaccinated? It’s only the flu, right? Besides, many parents claim that flu shots can give the flu to their children (not) and worst of all, my little junior hates shots. Why do I have to deal with this every year you may be asking? Which brings us to a recent excellent article by Dr. Mei Shang et al at the CDC.  Dr. Shang analyzed all the known pediatric deaths from influenza in the U.S. between the years 2010 until 2016. He discovered that 70% of those children who died from flu had not been vaccinated and that 1/2 of the those deaths occurred in children who were perfectly healthy prior to the having the influenza infection with no sign of asthma, diabetes, neurologic disorders, immune deficiencies or any other underlying complicating factors. This is new information since previously; we thought that most pediatric deaths from the flu were in children with pre-existing medical conditions. No, fully 1/2 of the deaths occurred in previously healthy children, most of whom were not immunized. What a shame. You can’t do much to prevent your children from heaven forbid coming down with leukemia but according to Dr. Shang, you can likely prevent them from having a severe life threatening case of influenza. Dr. Shang’s study also revealed that the most vulnerable children were those infants less than six months of age, too young to be vaccinated. Protecting them depends on vaccinating those around them and especially mom during pregnancy. Again, according to Dr. Shang, we are not doing too well at getting pregnant moms vaccinated, with only a 50% success rate in his sample.  I want you to factor all this into your decision whether or not to get your children vaccinated this fall.

Take home message:  Is the flu vaccine perfect-no/ is the flu shot some seasons not very protective-yes/ but in most seasons, it is about 70% protective. If I knew that 7 out of 10 times I visited Las Vegas I would win money, I would go regularly. I’d be in. In the same way, you should plan on a seasonal flu shot for all your children since there is a very good chance, it will protect them from a severe influenza infection.

Article #2– There has been a lot of talk about the safety of cough and cold medicines in children. We have talked about it quite a few times in the past on Portable Practical Pediatrics.  Yes, there have been deaths from children taking these medications and the CDC is strongly opposed to their use in children but how dangerous are they really?  To answer that question, Dr. Green from The Rocky Mountain Poison Control Center, looked at 4202 “events”, where a child or their family sought treatment and evaluation for a specific symptom or symptoms that was related to taking cough and cold medicines.  67% of these events occurred when a child had an unsupervised ingestion and 13% of them were attributed to a dosing error. The most common symptoms involved a child getting sleepy, having a rapid heart rate, hallucinating, or being agitated.  The chance of a child dying from one of these events was very low with 20 deaths of the 4202 events monitored. And here is the good news, of those children who got the recommended therapeutic dose, there were NO DEATHS. Hallelujah.

Take home message: While I think experts are in agreement that cough and cold medications are not helpful or needed by most children and that their use should be discouraged, if a parent does choose to use them and they are careful to use them at the recommended dose, the chance that their child will die from their use is extremely low. That’s not to say that they might not have an “event” but having that event lead to death is extremely unlikely. Bottom line though, save your money, keep these medicines out of your house, and use natural remedies like honey in children over 1 year, warm moist air, or even chocolate, all scientifically proven to reduce coughs in children. Yum.

Article #3– The next article comes out of Kaiser Permanente, Portland Oregon entitled “Cost Effectiveness of Cognitive Behavioral Therapy for Depressed Youth Declining Antidepressants”.  The authors compared the outcomes and cost of either treating a depressed teen with medications or what psychologists call cognitive behavior therapy- talk therapy. For more on CBT, check out a few previous posts I have done on the subject.  Anyway, the news is good.  Not only did CBT work better than taking antidepressant drugs but the CBT group was shown to have 26.8 more depression free days than drug group and the CBT group’s treatment cost $4976 less when looked at over a 2-year follow-up. I love this since I hate to see young people become dependent on chronic medications at a young age, especially antidepressants. Not only did CBT work better but it also saved these families a pile of cash.

Take home message: CBT may be a little more difficult to arrange and take up more of a parent’s time and energy to obtain but it seems to be a better treatment for depression in teens and may save money at the same time.

Article #4– This is a study out of the Bloomberg School of Public Health at Johns Hopkins entitled, “Ten Year Trends in Bullying and Related Attitudes Among 4th-12th graders”

I am sure you are aware of the very public push to protect bullied children and the growing literature that list bullying as a risk factor for both severe psychological harm and even suicide in its victims. Preventing bullying among children has become a front and center issue in our culture and it looks like all that attention is having a beneficial effect. In this study the authors collected data on 246,306 students and measured bullying over the past decade.  Their findings revealed that even though bullying is still common, occurring in about 22% of children between 4th and 12th grades, it has decreased significantly over the past decade.  The authors also concluded that children today feel that adults are more protective of them, and schools have become safer from bullying. All great things and good to hear.

Evidence shows that bullying cannot occur when responsible adults step in. Bullying occurs away from adults. Discovering it requires that you talk to your kids and ask about this issue, especially if they are struggling with anxiety or depression. And if it is occurring, step in and take action to protect your children. This is different than rescuing your child from bad grades or disagreements with friends, this is protecting your child from being repeatedly emotionally or physically intimidated and therefore harmed by another child.

Take Home message: Bullying is becoming less common, probably because of a lot of public attention to the issue and a society that is less willing to accept the bullying behavior. Bullying is still a big problem for many children and one that every parent needs to be on the lookout for and most importantly, take action if it is occurring.

Outro

Enjoy learning about child health with pedcasts; subscribe to the content at my blog, www.docsmo.com, on Apple podcasts, or Google podcasts. This is Doc Smo, helping parents take a little lurch into the world of pediatric research. Until next time.

Thanks to Drs. Charlotte Rouchouze and Monica Miller for their help in the preparation of this pedcast and to Logan Katz, age 12 from Atlanta GA, who graciously provided the introduction dialogue for today’s pedcast.

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