Aetna Latest Healthy Living News http://www.planforyourhealth.com/ Latest Healthy Living News from Aetna en Aetna Latest Healthy Living News http://www.planforyourhealth.com/ http://www.planforyourhealth.com/ Latest Healthy Living News from Aetna TYPO3 - get.content.right http://blogs.law.harvard.edu/tech/rss Fri, 19 Sep 2014 21:44:00 -0400 Study: Kids Get Double Antibiotics Needed http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/study-kids-get-double-antibiotics-needed/ Doctors prescribe antibiotics twice as often as needed for children with common respiratory...                    What Is the Doctor's Reaction? Lots of people think an antibiotic is needed for every infection a child gets. Not true. These drugs work only against bacteria, not other germs. Children get lots of acute respiratory tract infections every year. Five common infections involve the:
  • Ears (otitis media)
  • Sinuses (sinusitis)
  • Lungs (bronchitis)
  • Nose (upper respiratory infection, known as URI)
  • Throat (pharyngitis)
Viruses cause many of these infections. Antibiotics are not needed. Yet, they are still commonly prescribed. Each year, about 32 million doctor visits for breathing problems lead to antibiotic prescriptions. A study in the journal Pediatrics looked at how often bacteria cause these 5 common childhood infections. The answer was found in various studies done from 2000 to 2011. These 5 common infections occurred in 525 of 1,000 children each year. Of those who had these infections, bacteria were found in:
  • 65% of ear infections
  • 20% of throat infections
  • 78% of sinus infections
Researchers could not determine how often bacteria caused nose or lung infections. Then the researchers looked at a national survey about doctor visits by children less than 19 years between 2000 and 2010. During the 10 years of doctor visits studied, antibiotics were prescribed for these 5 infections 52% to 62% of the time. An antibiotic was prescribed for:
  • 86% of ear infections
  • 57% of throat infections
  • 89% of sinus infections
  • 24% of nose infections
  • 72% of lung infections
Some of these 5 infections are more common than others. For some, treatment guidelines recommend that many or all patients receive no antibiotics. So researchers calculated that overall doctors should have prescribed antibiotics 27% of the time for these 5 infections. Instead, they were prescribed more than twice as often (57%). The researchers found that about 11.4 million needless antibiotic prescriptions are written every year. It is not easy to separate bacterial and viral illnesses. Doctors should consider the findings from this study in making a decision to prescribe an antibiotic. What Changes Can I Make Now? When your child is sick, an antibiotic may not be the answer. Taking an antibiotic when it is not needed can do more harm than good. It may cause side effects. It also can increase your child's risk of getting an infection that is resistant to the antibiotic. That means the antibiotic will not work. Remember that antibiotics do not fight infections caused by viruses. These include:
  • Colds
  • Influenza (the flu)
  • Runny noses
  • Most sore throats
  • Most coughs
  • Most bronchitis (chest cold)
  • Most sinus infections
  • Some ear infections
Giving antibiotics will not make these infections go away any faster. They also will not help your child feel better. Luckily, these illnesses usually get better on their own within a week or so. If the doctor does not prescribe antibiotics, this does not mean your child is not sick. Talk with your doctor about ways to help your child feel better. She may recommend:
  • Plenty of rest
  • Lots of fluids
  • A cool-mist vaporizer in the child's bedroom
  • Saline (salt-water) nose drops to relieve stuffiness
  • Over-the-counter medicines, as directed
If your child has an infection the doctor believes is caused by bacteria, she may need an antibiotic. Give your child only the antibiotic that the doctor prescribes.
  • Do not skip any doses.
  • Finish the whole treatment, even if your child is feeling better.
  • Do not save any antibiotics to give the next time your child is sick.
  • Do not use one child's antibiotic for a sibling or friend.
  • Throw away unused antibiotics.
What Can I Expect Looking to the Future? Parents and doctors will work together to use antibiotics correctly. Parents should not always think taking one of these drugs is the answer. Your doctor also will suggest ways to help your child feel better without antibiotics. Antibiotics should be prescribed only when they are really needed. Doctors follow specific guidelines. They keep the following ideas in mind when deciding to use an antibiotic:
  • Whether or not bacteria are very likely to be causing the infection
  • The benefits and harms of using an antibiotic
  • Which antibiotic is the right one to use
  • Which is the right dose and the shortest period of time needed
Doctors also may discuss watch-and-wait strategies with you. This will help ensure that your child is taking the antibiotic for its intended use. Expect your child's doctor to remind you to give antibiotics exactly as they are prescribed.]]>
Mon, 15 Sep 2014 00:00:00 -0400
Infant Feeding and Long-Term Health http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/infant-feeding-and-long-term-health/ Breastfeeding leads to fewer ear, throat and sinus infections. But it doesn't lead to fewer colds,... What Is the Doctor's Reaction?
 
When it comes to feeding babies, there's lots of advice out there. What's particularly difficult about the advice, too, is that it's often given in a very "you must do this" matter of fact way. As if not doing it that way, could cause your baby irreparable harm. To make matters worse, the advice tends to vary -- even among doctors. Part of the reason for this is that while we think we know a lot about infant nutrition, what we often don't have is the long-term results of our advice. That's why a collection of studies just released in the journal Pediatrics, the official journal of the American Academy of Pediatrics, is so interesting. The studies all relate to the Infant Feeding Practices Study II, sponsored by the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention. In this study, they followed mothers and infants from the end of pregnancy through 12 months. In a follow-up, they checked in with them at age 6. Here are some of the findings of the studies:
  • Prolonged breastfeeding (several months) and delaying solid foods led to fewer ear, throat and sinus infections -- but had no effect on colds, lung infections or urinary infections.
  • Prolonged breastfeeding and delaying solids didn't change whether or not children were likely to have food allergies.
  • Breastfeeding doesn't actually help mothers lose their pregnancy weight faster -- unless they were obese during pregnancy, in which case it does make a difference.
  • Breast-fed babies have slightly healthier diets later in childhood: they are more likely to drink water (instead of juices or soda) and eat more fruits and vegetables. However, they are just as likely to eat sweets and snacks as children who were bottle-fed.
  • Giving sugar-sweetened beverages in infancy doubled the risk of obesity -- and doubles the chance that children will still be drinking them at age 6, which sets them up for future obesity.
  • If babies don't eat many fruits and vegetables, they are less likely to eat them when they are 6 years old. It wasn't possible to tell if this was a preference (the kids didn't like fruits and vegetables) vs. a family diet (the kids weren't served fruits and vegetables).
  • If babies were bottle-fed (either with formula or pumped breast milk), their mothers were more likely to try to get them to finish their food when they were 6 years old -- such as wanting them to eat all the food on their plate.
What Changes Can I Make Now? The bottom line is that good -- and bad -- eating habits start early. It really isn't so much a matter of breastfeeding vs. bottle-feeding, although breastfeeding can be very healthy for babies. It's more about getting children on the right track for healthy eating, right from the start. For instance:
  • Don't give children juices or sugar-sweetened beverages. They don't need them -- and they can be unhealthy. It's one habit to simply never start.
  • Start giving fruits and vegetables when children are babies, and not just in the baby food in jars. It's a health habit that can make all the difference. We should all eat five servings a day; if babies are eating that from the get-go, it's much less likely to be a struggle later.
  • Don't make children finish their food, whether it's a bottle of formula or the food on their plate. Let them listen to their own hunger cues. This can help prevent future obesity.
What Can I Expect Looking to the Future? Obesity is at staggeringly high rates in both adults and children. Studies like these can help us understand what we can do to prevent obesity. Hopefully people will listen to this advice -- and hopefully there will be more studies to help us make the best, healthiest decisions for our children.]]>
Tue, 02 Sep 2014 00:00:00 -0400
Doctors Push Later School Day for Teens http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/doctors-push-later-school-day-for-teens/ Most high schools and middle schools should start classes later in the morning, a large group of...                    What Is the Doctor's Reaction? If we want to improve the physical and emotional health of teenagers (and possibly their school achievement as well), there is a very simple thing we should do: start school later. That's the message of a policy statement released today by the American Academy of Pediatrics. In the statement, experts lay out clearly the reasons that a later school start could make a big difference for our teens. As any parent of a teenager knows, along with the pimples and moodiness, puberty brings changes in sleep patterns. Teens fall asleep later, and sleep later in the morning. This isn't just a case of wanting to stay up and watch TV. This is based in biology, changes that occur in body chemistry and circadian rhythms. You can send them to bed earlier, but they aren't going to fall asleep. However, on school days they can't sleep in to make up for the later bedtime. According to the statement, almost half of the more than 18,000 public high schools in the United States have start times before 8:00 a.m. Not surprisingly, that translates into less sleep for teens. According to a poll conducted by the National Sleep Foundation, 59% of middle school students and 87% of high school students get less than the recommended 8½ to 9½  hours of sleep. Some of them get much less. Interestingly, in the same poll most parents thought that their teens were getting enough sleep. So this was another point of the policy statement: to help people understand the importance of sleep for teens. The Sleep Foundation poll found that 28% of U.S. high school students fall asleep in class at least once a week. About 1 student in 5 falls asleep doing homework. This daytime sleepiness contributes to the poor academic performance that can result from not getting enough sleep. However, it's not just academic performance that suffers. Getting less than the recommended amount of sleep has also been linked with a higher risk of:
  • Anxiety and mood disorders
  • Drowsy driving and the car accidents that result
Sleep-deprived teens are more likely to use caffeine or prescription stimulants, with all the side effects they bring. And there are long-term effects as well. Long-term (chronic) sleep deprivation is linked to obesity, heart disease and diabetes. Some argue that a later school start time would just allow teens to stay up later. In that case, they wouldn't get more sleep. However, that isn't what has happened when schools have made the changes. Overall, what happens is that teens go to bed at the same time and end up with more sleep. What Changes Can I Make Now? Changes in school start times don't happen overnight. It may make abundant sense, but many logistics and negotiations need to take place before it can happen. And the many challenges and obstacles must be addressed. For example, a later start may lead to less time for sports and other activities. In the meantime, there are many things that parents and others who work with youth can do to help them get more sleep. School days that start early are not the only problem. Students have many demands on their time. As a society, we need to take a step back and do some real thinking about the effects of our achievement culture on our youth. We also need to look more closely at the role of electronic media. Teens may stay up even later because they want to use media. And media also keep them awake. More and more teens are drinking caffeinated beverages as well, which leads to sleep problems. As parents, we should be very aware of the demands on our teens, as well as what they are doing in their rooms late at night. What Can I Expect Looking to the Future? I hope that school administrators and community leaders will take this policy statement seriously. I hope they will look for ways to start middle school and high school at a time that works better with the biological realities of youth. Hopefully, too, the policy statement will spur conversations about other ways that we can help our youth get more sleep. If either happens, it could make all the difference for teens.]]>
Mon, 25 Aug 2014 00:00:00 -0400
Best Flu Vaccines for Seniors, Kids http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/best-flu-vaccines-for-seniors-kids/ The nasal flu vaccine is more effective for young children, and the high-dose flu shot may be... What Is the Doctor's Reaction? Protection against influenza keeps getting better. The U.S. Advisory Committee on Immunization Practices just released updated advice for this coming flu season. The big change is that there is now a preferred vaccine for many younger children. And new research shows that older adults have better flu immunity if they receive a high-dose flu shot. The New England Journal of Medicine published the study results yesterday. Here are some key points in this year's flu vaccine advice:
  • The flu strains covered by the 2014-2015 vaccines will be similar to what was covered last season.
  • A child, ages 6 months to 8 years, who received at least one dose of flu vaccine last season will need only a single dose of this season's vaccine. Two doses are required if no vaccine was given last season.
  • Live attenuated influenza vaccine (FluMist) squirted into the nose is the preferred vaccine for children ages 2 to 8 years. It provides better protection than the flu shot in this particular age group. The flu shot contains no live virus.
The advisory committee did not say anything new about the high-dose flu vaccine (Fluzone) for adults 65 years and older. However, the results of the study published yesterday show that it is better than standard-dose vaccine for this group. The standard vaccine protects about 60% of adults from getting the flu. Protection is lower in adults 65 and older, about 50% effective. Fluzone High-Dose contains inactivated particles of virus. It is given as a shot. It has four times as many of these particles as the standard vaccine. This translated into:
  • A more potent immune response, as measured by antibody levels in the blood
  • A 24% lower risk of getting sick with the flu for older adults in the study
The researchers estimate that the high-dose flu shot provides seniors with the same level of protection that younger adults receive from the standard flu shot. The high-dose vaccine can cause more side effects. These may include short-term, low-grade fever, discomfort at the injection site and general achiness. But it appears to be just as safe the standard vaccine. In this study, fewer people who received the high-dose vaccine reported serious side effects than those who got the standard dose. What Changes Can I Make Now? With some rare exceptions, everyone 6 months and older should get a yearly flu vaccine. Depending on your age and medical conditions, some types of vaccine may be better for you than others. But it is more important to get vaccinated with the standard flu shot if that is the only one available. The high-dose flu shot and FluMist also might be more costly for some people. What Can I Expect Looking to the Future? Scientists will continue to get better at predicting which strains to include in the yearly flu vaccine. And they will discover new ways to make the shots more effective.]]>
Fri, 15 Aug 2014 00:00:00 -0400
Study Links Mental Delays, Behavior Problems http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/study-links-mental-delays-behavior-problems/ Babies with delays in mental development may be more likely to have behavior problems later.... What Is the Doctor's Reaction? Sometimes there is more to a fussy baby or a toddler having a tantrum than meets the eye. Difficult behavior -- such as fussiness, tantrums, aggression or clinginess -- is very common in babies and young children. It's so common, in fact, that we don't think anything of it. If we see it in someone else's child at the park or store, we often chalk it up to poor parenting. But sometimes behavior problems can be a sign of something else: a cognitive delay. "Cognitive delay" means that a child learns or understands something later than others the same age. Cognitive delays are different from motor delays. With a motor delay, a child does something physical (such as sitting or crawling) later than other children. A child with a cognitive delay might take longer to talk, or understand words, or figure out how to play with another child. It's easy to understand why a child with cognitive delays might have behavior problems. If a child doesn't understand that when his mother leaves she will come back, he might get extremely upset every time she leaves. If a child can't explain what she wants, she may throw tantrums out of frustration. And if a child doesn't understand the concept of sharing a toy, she may hit or otherwise be aggressive toward a child who is playing with a toy she wants. Researchers were interested in knowing if there were links between cognitive delays and behavior problems. In particular, they wanted to find out how this played out over time. Because for many children, delays are just that: delays. With a little time, the children catch up completely with their peers. Other children don't catch up. In that case, the delays become a sign of a bigger problem. The researchers studied 8,000 children from the Early Childhood Longitudinal Study. They looked at the children's development as well as signs of behavior problems. Examples of behavior problems included:
  • Being fussy
  • Showing aggression
  • Getting easily upset
  • Demanding attention
  • Breaking things
  • Having tantrums
  • Being overly active
  • Having sleep problems
  • Having difficulty engaging in tasks
  • Being distractible
The good news from this study is that researchers found cognitive delays got better in 80% of the children who were found to have them at age 9 months. As for behavior problems, they were indeed more common in children with cognitive delays. Problems were noted as early as 9 months.  About 1 in 5 children with cognitive delays that got better had a behavior problem. In children whose delays didn't get better, that rose to 1 in 3. What Changes Can I Make Now? As I said before, most of the time behavior problems in children are entirely normal. They may be related to the situation or the child's temperament. Sometimes they are related to parenting. (Setting consistent, loving limits can make all the difference.) But sometimes they are a sign of a bigger problem. If your child is having persistent problems with behavior, talk to your doctor. Even when it's not a sign of a bigger problem, your doctor can help you sort out what's triggering the behavior and help you come up with strategies to manage it. But if your child is showing any signs of delays in development, it might be a good idea to have a developmental evaluation done. This will help determine if there are any problems that should be addressed. If there are, the sooner you find them, the sooner you can get your child help -- and that can make a big difference with cognitive delays. What Can I Expect Looking to the Future? What I want most as a pediatrician is for my patients to have the best future possible. Finding problems early -- and getting help for them quickly -- makes that more likely. I hope that this study, and others like it, will help children live happier, healthier lives.]]>
Mon, 11 Aug 2014 16:18:00 -0400
Kids May Be Happier with a Little Gaming http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/kids-may-be-happier-with-a-little-gaming/ Kids who play video games, but for less than an hour a day, may be better adjusted than those who... What Is the Doctor's Reaction? Video and computer games can be fun. Some children spend hours a day playing them. Many parents wonder, "Is this bad for my child?" A new study in the journal Pediatrics looked at some of the positive and negative effects of playing electronic games. Researchers wanted to know how the amount of time spent playing these games affects a child's social adjustment. The researchers gave surveys to almost 5,000 boys and girls. Their ages ranged from 10 to 15. The children and teens were asked how much time they spent playing video or computer games each day. The choices were:
  • 0 hours (non-player)
  • Less than 1 hour (light player)
  • 1 to 3 hours (moderate player)
  • More than 3 hours (heavy player)
They then were asked about:
  • Positive behaviors (such as helping others and caring about people's feelings)
  • Negative behaviors (such as having trouble paying attention and not getting along with others)
  • Level of happiness (about school, friends, family and how they looked)
The researchers found that compared with non-players:
  • Light players reported more positive behaviors and feelings and fewer negative ones
  • Moderate players reported no difference in positive or negative behaviors and feelings
  • Heavy players reported more negative behaviors and feelings and fewer positive ones
The researchers say that the differences between groups were small, but still important. Playing electronic games for less than an hour a day was linked with good social adjustment in this study. In contrast, playing for more than three hours a day was linked with poor social adjustment. What Changes Can I Make Now? Make sure your child spends his free time doing things that will help him develop a healthy mind and body. Great options include:
  • Reading
  • Playing outside
  • Taking part in sports
  • Spending time with friends
Playing video or computer games some of the time is OK. It may even have some benefits for your child. But playing them too much may:
  • Keep your child from getting needed exercise
  • Interfere with schoolwork and household chores
  • Possibly lead to aggressive behavior (if it is a violent game)
  • Affect your child's friendships
This is why it is important to monitor and limit the amount of time your child spends playing electronic games. The American Academy of Pediatrics recommends no more than 2 hours of "screen time" a day. This includes watching TV or movies, playing video games and using the computer, smart phones or tablets.  A child under 2 years old should have no screen time at all. If your child wants to play a video or computer game, consider these tips:
  • Make sure the game is suitable for her age. The Entertainment Software Rating Board rates video games. Stay away from games rated "M" for mature (for ages 17 and older). These can have extreme violence, sexual content or both.
  • Preview the game. Even with ratings, it is still important to preview the game before letting your child play. The game's rating may not match what you feel is right for your child.
  • Keep the video game console or computer in an open, common area of the house (not the bedroom). This way, your child will be able to interact with others in the house while playing. It will also let you keep track of the types of games and how much she is playing.
  • Watch your child's behavior. Look to see if he seemsmore aggressive after playing a violent game. Discuss the game with him. Explain that the violence in the game is different from what happens in real life and why.
  • Think about "active" video games. Some games do get your child moving. Remember, though, that this is not the same level of exercise as playing outside or taking part in sports.
What Can I Expect Looking to the Future? This study gives us a better idea of how electronic gaming might affect a child's development. Expect your child's pediatrician to talk with you about limiting video games and other screen time. More research is needed to understand how electronic gaming influences children. It seems to be more than just limiting play. Future studies will look at differences based on the type of game, why the child is playing and the child's level of engagement. This will better inform guidelines for electronic gaming made by parents, health professionals and policymakers.]]>
Tue, 05 Aug 2014 14:31:00 -0400
Doctors Condemn Fla. Gun-Law Ruling http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/doctors-condemn-fla-gun-law-ruling/ Medical groups have denounced a court decision upholding a Florida law that forbids doctors from... th Circuit Court of Appeals reversed that decision July 25. The court said that "inquiring about a private matter irrelevant to medical care isn't part of the practice of good medicine." Several doctors' groups disagreed. The American Academy of Pediatrics called the decision "an egregious violation of the First Amendment rights of pediatricians." Many children's doctors ask about guns in the home. They offer advice on safe storage to help keep guns away from children. On August 1, a new coalition of 20 medical groups also decried the ruling. The coalition said the issue is "much bigger than gun safety." Doctors talk to patients about things that could affect their health and safety. "Government intrusion" in this process could put patients' health at risk, the group said. Med Page Today wrote about the reactions. What Is the Doctor's Reaction? On Friday morning, a newly formed group called the Coalition to Protect the Patient-Provider Relationship released a strongly worded statement in opposition to Florida's gun-safety counseling law. The coalition is a nonpartisan, nonprofit group of health-care professionals. It includes doctors, students, nurses and lawyers from 20 different organizations. Briefly, the Florida Legislature passed a law in 2011 that forbade doctors from asking their patients whether they owned a gun unless it was directly relevant to patient care. The law was overturned by a U.S. district court. The court said it violated the doctors' rights under the First Amendment of the U.S. Constitution -- the right to free speech. Last week, however, a U.S. appeals court said that the law could stand. The court said that the practice of good medicine does not require questions about irrelevant, private matters.    The new coalition issued a strongly worded statement that addressed two issues. The first is firearms safety. The second, and larger, issue is about government intrusion on patients' relationships with their health-care professionals.  Under the Florida law, medical caregivers are not protected by the First Amendment when they ask whether people have guns in their homes.  Doctors, particularly those who care for children and families, often ask about guns in the home. They do this in order to counsel families about gun safety.  Research shows that this kind of counseling and education can decrease the likelihood of injury and death.  Intrusive questions are part of a comprehensive health assessment! I ask a patient about gun safety to help prevent injuries and accidents. For most doctors, this doesn't feel very different than asking people about using alcohol or drugs, about smoking, about exercise and diet. I ask young people about birth control or what they might do if they or their partner had an unplanned pregnancy. I ask older people about things that might increase their risk of falling. I ask depressed people about whether they have plans to harm themselves. I ask men and women if they are safe in their relationships. Part of my job is to help people to consider their health and safety risks and to think about ways to reduce those risks.  As important as the specifics of the ruling are, the issue of government intrusion on the doctor-patient relationship is particularly worrisome to me and to members of the coalition. The relationships between health professionals and patients need to be based on privacy, trust, and respect.  In order to really take good care of you, your doctor needs to be able to ask some difficult questions. You need to be able to trust that your doctor is trying to help you, not judge you. You need to know that your doctor will keep what you say confidential. When the government gets involved in this type of private conversation, it's bad medicine -- for everyone. Your doctors might be afraid to ask an important question. You might be afraid to tell your doctor the truth. When secrets, lies and fear dominate a medical conversation, everyone gets hurt.  I strongly believe that medical caregivers should be able to ask about factors that affect patients' risk of harm -- including firearms. I also fear the slippery slope of involving a third party -- the law -- into what should be a private and personal dialogue, based on trust. What Changes Can I Make Now? If you have firearms or other weapons in your home, be sure to store them in a locked cabinet. Children should not be able to get the keys. Ideally, lock up the gun's ammunition, too -- in a different and separate place. If you have questions, talk to your health-care professional about the best way to keep your family safe. Even in Florida, the law does not prevent a patient from asking his or her doctor a question! If you share the new coalition's concerns about the Florida law, then make your voice heard. If you are a resident of Florida, write to your state legislators. Let them know if you don't think this is a good or safe law. Urge them to craft better legislation. If you live in another state and have concerns about the Florida law, reach out to your own elected officials. Let them know that you feel that doctors should not be limited in the questions they can ask patients. Let them know that you want your doctor to be able to address issues of health and safety in a private, confidential, nonpolitical setting. What Can I Expect Looking to the Future? I doubt that we've heard the last about this law. I would expect further appeals. The decisions made about this law could truly impact all of us.]]> Mon, 04 Aug 2014 14:34:00 -0400 RSV Drug Recommended for Fewer Babies http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/rsv-drug-recommended-for-fewer-babies/ A large group of children's doctors says that only certain high-risk babies should receive a drug... What Is the Doctor's Reaction? The winter is coming. Your baby might get a runny nose and a cough. Maybe even a fever. Is it respiratory syncytial virus (RSV)? Could be. Almost all children are infected with RSV by the age of 2. RSV infections continue throughout life. RSV tends to be less of a concern as children get older. RSV causes cold-like symptoms. When the upper airway is the problem, it is called an upper respiratory infection. When the lungs (lower airways) are the issue, it is called bronchiolitis. RSV infection can be more severe in certain babies who:
  • Are very premature (born much earlier than expected)
  • Have health conditions that affect the heart, lungs or immune system
There is one drug that may help certain babies. It is called palivizumab (pah-lih-VIH-zu-mahb). This drug is an antibody. It is made from a substance in blood that helps to protect against a specific disease. It is given as a series of monthly shots. The American Academy of Pediatrics (AAP) has carefully analyzed all studies that have been published on RSV and palivizumab together. This includes:
  • When RSV circulates in different parts of the United States
  • What factors increase the risk of having problems with RSV
  • How often babies have a hospital stay (or die) from RSV bronchiolitis
  • How palivizumab works in the body
  • How well this drug prevents wheezing in the future
  • Drug resistance
  • Costs
Many other experts from around the country provided input. This complete science review guided the AAP's latest advice on the use of palivizumab. The journal Pediatrics just published the updated policy statement. Palivizumab is not for all infants. Research suggests that it works best to reduce serious lung infections caused by RSV in babies who have an increased risk of severe disease. Therefore, the AAP now recommends palivizumab only for high-risk children who are most likely to benefit. These include:
  • Infants born before the 29th week of pregnancy who are younger than 12 months at the start of RSV season
  • Infants with chronic lung disease of prematurity (born earlier than the 32nd week of pregnancy and requiring extra oxygen for at least the first 28 days after birth)
  • Infants with certain heart problems
  • Children under 2 years old with severe immune problems during the RSV season
  • Some Alaskan Native or American Indian infants
The AAP now has a much better understanding of which babies are at risk. As with any drug, it is important to use palivizumab in children most likely to benefit from it. What Changes Can I Make Now? If your baby is at increased risk of severe RSV disease, palivizumab during RSV season may help. It means going to the doctor each month to get a shot in the muscle. Remember that during these monthly visits, babies may be exposed to a different infection, such as influenza, by other children in the office. Your baby's doctor can help you decide if the baby might benefit from this drug. The latest AAP advice means that a more focused group of children is eligible for palivizumab than in years past. But this does not mean that more children will be at risk for severe RSV infection. The AAP recommends palivizumab for only a very small number of infants because the evidence shows that the benefit is so limited. Palivizumab does not prevent RSV. It has been shown to only modestly reduce how often children have to stay in a hospital for bronchiolitis treatment. It has not been shown to lower death rates. It has minimal effect on reactive airways disease and asthma. RSV spreads easily from person to person. Children are most likely to catch it during the RSV season. This usually lasts from November to April. Here are some things you can do to protect your baby from RSV:
  • Breastfeed your baby. Breast milk provides antibodies, which help fight infection.
  • Wash your hands with warm water and soap before picking up and holding your baby.
  • Cough or sneeze into your elbow or upper arm.
  • Wash objects that are touched a lot, such as toys. Use a disinfectant wipe or a cloth with soap and hot water. (A disinfectant is a cleaner that kills germs.)
  • Do not smoke around your baby. Secondhand smoke increases the risk of a serious RSV infection.
  • Try to steer clear of anyone who seems to have a cold. 
  • Keep your baby away from crowded areas, such as shopping malls and elevators. RSV spreads more easily when there are lots of people around.
  • Avoid large-group child care during RSV season.
What Can I Expect Looking to the Future? The AAP still believes that palivizumab is helpful for babies at greatest risk from RSV infection. Experts will keep studying, analyzing and reviewing the data on palivizumab and RSV. As new studies are published, guidelines might change again. An RSV vaccine would provide even better protection. Researchers are working on making a safe and effective vaccine against RSV.]]>
Mon, 28 Jul 2014 18:52:00 -0400