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Posts for: January, 2014

January 27, 2014
Category: In the News
Tags: Untagged

Flu Season Continues; Severity Indicators Rise

CDC continues to urge vaccination and rapid treatment with antiviral drugs for people at high risk of serious flu complications including pregnant women, people who are morbidly obese and people with metabolic disorders

January 17, 2014 – H1N1 flu continues to cause a lot of illness across the country and flu-related hospitalization and death indicators are up this week from last, according to CDC’s latest FluView report. The estimated proportion of flu- and pneumonia-related deaths is now above the epidemic threshold for the first time this season; this means that more pneumonia and influenza deaths are occurring than expected for this time of year. Additionally, the number of pediatric deaths reported to CDC this season doubled this week from 10 to 20. More than 60 percent of hospitalizations continue to occur in people between the ages of 18 and 64: while this is a somewhat unusual pattern for seasonal flu, a similar age distribution for hospitalizations was seen during the 2009 H1N1 pandemic. The pandemic was the last time that H1N1 viruses were the predominant circulating flu virus. Taken together, these indicators underscore the impact that seasonal flu is having on the United States, particularly on younger people.

CDC continues to recommend that people who have not gotten vaccinated yet this season get vaccinated now. While activity may be declining in states where the season began earlier, nationally the country is likely to experience several more weeks of high flu activity as flu spreads to other states. The number of states reporting high influenza-like-illness fell from 20 to 14 this week, but the number of states reporting widespread flu activity increased from 36 to 40.

CDC also is reminding clinicians and members of the public at high risk for serious flu complications about the importance of rapid antiviral treatment. Influenza antiviral drugs are a second line of defense against the flu; prompt treatment can reduce serious illness and death. These drugs work best when started soon after influenza symptoms begin (within 2 days), but persons with high-risk conditions can benefit even when antiviral treatment is started after the first two days of illness.

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January 24, 2014
Category: In the News
Tags: Untagged

Parenting Workshops with Dr. Jonathan Schwab and Sharon Saline, Psy.D.
Sunday, February 9th
4:30pm to 6:00pm

193 Locust St., Northampton

Sleep Matters: Practicing Good Sleep Hygiene in your Home
This talk will examine the sleep needs, behaviors and disturbances across the developmental spectrum from infancy to adolescence.

Please RSVP by calling 413-517-2226 or email
Light refreshments will be served.

Sunday, March 9, 2014
4:30pm to 6:00pm
Back by popular demand!
Understanding ADHD and ADD in Children and Teens   


Sunday, April 6, 2014

4:30pm to 6:00pm

Parenting Preschoolers with Confidence and Consistency

January 24, 2014
Category: In the News
Tags: Untagged

Dear Parents and Patients,

We wish to inform you that we will not be able to retrieve any types of messages or requests submitted through the Patient Portal after 5pm on Saturday January 25, 2014 through Monday January 27, 2014.

We apologize for this temporary inconvenience.

Thank you,

January 15, 2014
Category: In the News
Tags: Untagged

Unexplained rash? It could be MCI/MI in your baby wipes

Christopher C. Chang, M.D., Ph.D, Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
POSTED: MONDAY, JANUARY 13, 2014, 12:05 AM

Has your child had a severe rash that couldn't be treated with topical creams and oral antibiotics and steroids? It could be contact with a substance which contains a combination preservative designated as MCI/MI (Methychloroisothiazolinone or Methylisothiazolinone) found in some baby wipes.

An article released today from Pediatrics describes six cases of a stubborn contact dermatitis to what is generally considered to be an innocuous product – baby wipes. The wipes were not immediately suspected to be the culprit, but despite active treatment with multiple topical and oral antibiotics and steroids, the rash only resolved after discontinuation of the wipes. It turned out that these wipes had MCI/MI.

Baby wipes are generally very safe and the presence of MCI/MI in baby wipes had not previously been reported to be an extensive problem in infants. However, all the patients in the article were patch tested and were found to be positive for MCI/MI.

Besides baby wipes, MCI/MI is found in many common products around the home, including cosmetics, cleaning products, waxes and polishes, paints, skin creams, tanning products, hair care products, laundry products and personal hygiene items such as soaps and wet wipes. The rash of an allergic contact dermatitis can be red, raised and even blistery or weepy. A good example of the rash of allergic contact dermatitis is that of poison oak or poison ivy dermatitis. If your child has an unexplained contact dermatitis looking rash, then it is reasonable to think of products that may contain MCI/MI that are coming in contact with his or her skin.

It should be noted that not all baby wipes contain MCI/MI, so reading labels is important. If your child has an unexplained rash with the features described above, see your allergist or dermatologist. If it is not obvious by history what the rash is due to, your doctor may be able to do a patch test to determine the cause. If it is indeed MCI/MI, then the best way to treat this is prevention, which means avoidance of any product with these ingredients. 

Here’s what to look for on a label:

  • Methychloroisothiazolinone
  • Methylisothiazolinone

The prevalence of MCI/MI contact allergy has increased significantly in recent years, so much so that the substance had the dubious distinction of being named the 2013 “Allergen of the Year” by the American 
Contact Dermatitis Society (ACDS)!

January 10, 2014
Category: Uncategorized
Tags: Untagged

Bad Eating Habits Start in the Womb

NY Times
Published: December 1, 2013

The solution to one of America’s most vexing problems — our soaring rates of obesity and diet-related diseases — may have its roots in early childhood, and even in utero.

Researchers at the Monell Chemical Senses Center, a nonprofit research organization in Philadelphia, have found that babies born to mothers who eat a diverse and varied diet while pregnant and breast-feeding are more open to a wide range of flavors. They’ve also found that babies who follow that diet after weaning carry those preferences into childhood and adulthood. Researchers believe that the taste preferences that develop at crucial periods in infancy have lasting effects for life. In fact, changing food preferences beyond toddlerhood appears to be extremely difficult.

“What’s really interesting about children is, the preferences they form during the first years of life actually predict what they’ll eat later,” said Julie Mennella, a biopsychologist and researcher at the Monell Center. “Dietary patterns track from early to later childhood but once they are formed, once they get older, it’s really difficult to change — witness how hard it is to change the adult. You can, but it’s just harder. Where you start, is where you end up.”

This may have profound implications for the future health of Americans. With some 70 percent of the United States population now overweight or obese and chronic diseases skyrocketing, many parents who are eating a diet high in processed, refined foods are feeding their babies as they feed themselves, and could be setting their children up for a lifetime of preferences for a narrow range of flavors.

The Monell researchers have identified several sensitive periods for taste preference development. One is before three and a half months of age, which makes what the mother eats while pregnant and breast-feeding so important. “It’s our fundamental belief that during evolution, we as humans are exposed to flavors both in utero and via mother’s milk that are signals of things that will be in our diets as we grow up and learn about what flavors are acceptable based on those experiences,” said Gary Beauchamp, the director of the Monell Center. “Infants exposed to a variety of flavors in infancy are more willing to accept a variety of flavors, including flavors that are associated with various vegetables and so forth and that might lead to a more healthy eating style later on.”

There is another reason these exposures have a lifelong impact, he said: “This early exposure leads to an imprinting-like phenomenon such that those flavors are not only preferred but they take on an emotional attachment.”

This puts babies fed formula at a disadvantage because the flavors in packaged formula never change. But according to Ms. Mennella, the opportunity to expose those babies to a range of flavors is not lost. “Just because you’re formula-fed, it’s not hopeless,” she said.“Babies learn through repeated exposure, so the more varied the diet, the more likely they’ll be to accept a novel food.”

Another recent study conducted at the FoodPlus research center at the University of Adelaide in South Australia found that exposure to a maternal junk food diet (defined in the study as any food that was energy dense, highly palatable and had a high fat content) results in children with a preference for these same foods. In a rodent model, the study found that being exposed to too much junk food in utero and through breast milk leads offspring to develop a reward pathway in the brain that is less sensitive than normal. Mothers who were fed foods like Froot Loops, Cheetos and Nutella during pregnancy had offspring that showed increased expression of the gene for an opioid receptor, which resulted in a desensitization to sweet and fatty foods. “The best way to think about how having a desensitized reward pathway would affect you is to use the analogy of somebody who is addicted to drugs,” Jessica R. Gugusheff, a Ph.D. candidate at FoodPlus and the lead author of the study, wrote in an email. “When someone is addicted to drugs they become less sensitive to the effects of that drug, so they have to increase the dose to get the same high,” she wrote. “In a similar way, by having a desensitized reward pathway, offspring exposed to junk food before birth have to eat more junk food to get the same good feelings.”

Ms. Mennella at Monell has also done research on reward pathways for sweetness and has found that sweet flavors have an analgesic effect on babies and children such that babies will cry less and children will leave their hand in a cold water bath for longer periods with sweet flavors in their mouths. Ms. Mennella has also found that in obese children, while the level of sweet they prefer is the same as that of normal-weight children, sweet flavors are not as effective as an analgesic. “I hypothesized maybe it’s because of some disruption in the opioid system, so maybe they need more sweet to get the same effect,” she said.

These research studies call into question the ethics of marketing poor-quality foods to children as well as the marketing of infant formula.

In the United States, according to the Centers for Disease Control and Prevention, about 15 percent of mothers breast-feed exclusively for six months, with rates significantly lower for African-American mothers. The American Academy of Pediatrics recommends that women breast-feed exclusively for at least six months and then continue some breast-feeding as they introduce solid foods for the next six months. The World Health Organization recommends breast-feeding up to 2 years of age or beyond.

But infant formula is a booming billion-dollar industry with three companies controlling almost 98 percent of the market: Mead Johnson, maker of Enfamil, Abbott, manufacturer of Similac, and Nestlé (now Gerber), maker of Good Start.

Functional foods, or foods that allegedly deliver nutritional benefit beyond what is available in natural foods, are a food industry creation to convince consumers that their products are superior to, or can replace, natural, whole foods. Globally, infant formula is the fastest growing functional food; the market is on track to grow by nearly $5 billion in 2013 alone.

But formula is only part of the problem since breast-fed babies of mothers eating too many refined and processed foods are also at risk. Claims by the food industry that personal responsibility, exercising more, and eating less are the solutions to obesity and diet-related disease are turned on their head with these studies. If babies are developing food preferences in utero and before 2 or 3 years of age through no fault of their own, how can we then blame them when they become obese children and adults?

If we hope to reverse the tide on obesity and diet-related disease in America, regulating processed food products and infant formula, and creating clear warning labels to deter parents from feeding their children potentially harmful foods may be our best shot. Let’s make sure future generations have the best chance to become healthy adults.


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