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The Informed Parent

What’s Up Doc?

by John H. Samson, M.D., F.A.A.P.
Published on Oct. 17, 2011

The American Academy of Pediatrics publishes a monthly collection of studies under the title “Grand Rounds”. I will summarize several articles that appeared in this publication:

February 2010

 “Visual Assessment of Jaundice in Newborns,”  Karen R. Tremont,

They point out how inaccurate it is for physicians or nurses to predict the level of jaundice in a newborn. This is a well-known fact; and that is why so many bilirubins are done at the expense of the neonate’s heels.

A comment by Dr. Echinwald of Texas Children’s Hospital states that the use of trans cutaneous bilirubin testing (measuring the level of skin yellowness by a photometric device) could prove helpful if done prior to discharge. And a follow-up blood bilirubin would be done on the higher levels.

I feel this would be helpful when adequate testing trials prove that this device is accurate. Not only would it decrease the number of heel sticks, but it might prevent the development of kernicterus (bilirubin deposition brain damage). This is being carefully studied across the country. Stay tuned for developments.

February 2010

“Safety of Oral Immunotherapy is Peanut Allergy”, A. Hoffman, 

The investigators in a limited study send us hope that giving repeated small doses of peanut protein in escalating doses proved useful in their hands. They encountered systemic reactions that could be managed.

A comment by Dr. Nimmagadda from Northwestern School of Medicine sums it up very well. “Until more experience is gained from larger long-term studies, oral immunotherapy should not be tried in a clinical practice setting.” Nevertheless, it sounds promising and I am waiting with baited breath.

June 2010

“Dietary Salt Reduction Reduces Cardiovascular Disease”, K. Bibbins-Domingo,

In their article that appeared in the NEJM, it clearly showed that by decreasing the salt load in children the incidence of heart and vascular disease could be reduced. Comments by prominent pediatricians support their conclusion.

It is time for us all to reduce the salt intake in our children as well as ourselves. They point out that salt use is as prominent a problem as obesity and tobacco use. 

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