Men’s Brains Respond Differently to Hungry Infant’s Crying

Researchers have uncovered firm evidence for what many mothers have long suspected: women’s brains appear to be hard-wired to respond to the cries of a hungry infant.

Researchers asked men and women to let their minds wander, then played a recording of white noise interspersed with the sounds of an infant crying. Brain scans showed that, in the women, patterns of brain activity abruptly switched to an attentive mode when they heard the infant cries, whereas the men’s brains remained in the resting state.

“Previous studies have shown that, on an emotional level, men and women respond differently to the sound of an infant crying,” said study co-author Marc H. Bornstein, Ph.D., head of the Child and Family Research Section of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the institute that conducted the study. “Our findings indicate that men and women show marked differences in terms of attention as well.”

The earlier studies showed that women are more likely than men to feel sympathy when they hear an infant cry, and are more likely to want to care for the infant.

Dr. Bornstein collaborated with Nicola De Pisapia, Ph.D., Paola Rigo, Simona DeFalco, Ph.D., and Paola Venuti, Ph.D., all of the Observation, Diagnosis and Education Lab at the University of Trento, Italy, and Gianluca Esposito, Ph.D., of RIKEN Brain Science Institute, Japan.

Their findings appear in NeuroReport.

Dr. Bornstein says this research not only helps understand the specific wiring of the brain, but helps understand how the brain has developed. (MP3 – 00:01:12, 1,140 KB)

Transcript – Dr. Bornstein says this research not only helps understand the specific wiring of the brain, but helps understand how the brain has developed.

Previous studies have shown differences in patterns of brain activity between when an individual’s attention is focused and when the mind wanders. The pattern of unfocused activity is referred to as default mode, Dr. Bornstein explained. When individuals focus on something in particular, their brains disengage from the default mode and activate other brain networks.

For about 15 minutes, participants listened to white noise interspersed with short periods of silence and with the sounds of a hungry infant crying. The patterns of their brain activity were recorded by a technique known as functional magnetic resonance imaging.

The researchers analyzed brain images from 18 adults, parents and nonparents. The researchers found that when participants listened to the typical infant cries, the brain activity of men and women differed. When hearing a hungry infant cry, women’s brains were more likely to disengage from the default mode, indicating that they focused their attention on the crying. In contrast, the men’s brains tended to remain in default mode during the infant crying sounds. The brain patterns did not vary between parents and nonparents.

Infants cry because they are distressed, hungry, or in need of physical closeness. To determine if adults respond differently to different types of cries, the researchers also played the cries of infants who were later diagnosed with autism. An earlier study of Dr. Bornstein and the same Italian group found that the cries of infants who develop ASD tend to be higher pitched than those of other infants and that the pauses between cries are shorter. In this other study, both men and women tended to interrupt their mind wandering when they heard these cries.

“Adults have many-layered responses to the things infants do,” said Dr. Bornstein. “Determining whether these responses differ between men and women, by age, and by parental status, helps us understand instincts for caring for the very young.”

In an earlier study, Dr. Bornstein and his colleagues found that patterns of brain activity in men and women also changed when they viewed an image of an infant face and that the patterns were indicative of a predisposition to relate to and care for the infant.

Such studies documenting the brain activity patterns of adults represent first stages of research in neuroscience understanding how adults relate to and care for infants, Dr. Bornstein explained. It is possible that not all adults exhibit the brain patterns seen in these studies.

Source: National Institutes of Health (NIH)

FDA Awards Grants to Encourage Pediatrics Medical Device Development

The U.S. Food and Drug Administration today announced the awards of three grants to boost the development and availability of medical devices for children.

A panel of five experts with experience in medicine, business, and device development reviewed 10 applications for the grants, which will be administered by the FDA’s Office of Orphan Products Development. The recipients and grant amounts include:

• James Geiger, M.D. and Andre Muelenaer, M.D. of the University of Michigan Pediatric Device Consortium and the Pediatric Medical Device Institute Pediatric Medical Device Consortium, $1.1 million a year for two years.
• Michael Harrison, M.D. and the University of California, San Francisco Pediatric Device Consortium, $500,000 a year for two years.
• Barbara Boyan, Ph.D. and the Atlanta Pediatric Consortium, $900,000 a year for two years.

“Congress provides FDA with this funding so that we can help connect innovators and their ideas to experienced professionals who can assist them through development,” said Debra Lewis, O.D., acting director of the FDA’s Office of Orphan Product Development. “Development of medical devices for children lags up to a decade behind similar devices used in adults.”

Children differ in terms of size, growth, and body chemistry and present unique challenges to device designers. In addition, the activity level and ability to manage some implantable or long-term devices may vary greatly among children. While this program is administered by the Office of Orphan Products Development, it is intended to encompass devices used in all pediatric diseases, not just rare diseases.

Legislation passed by Congress in 2007 established funding for grants to nonprofit groups to help stimulate projects to promote the development and availability of pediatric medical devices. These grants are meant to encourage the development of multiple pediatric device projects. While a small portion of the grants fund specific projects, the real spirit of this grant program is to provide information clearinghouses to promote multiple projects.

This is the second round of this type of biennial grants to be awarded. Those receiving these grants will:

  • encourage innovation and connect qualified individuals with good pediatric device ideas to potential manufacturers
  • mentor and manage pediatric device projects through their development, including prototype design and marketing
  • connect innovators and physicians to existing federal and non-federal resources
  • assess the scientific and medical merit of proposed pediatric projects and provide assistance and advice on business development, training, prototype development and post-marketing needs.

As part of the legislation, each of the grant recipients will coordinate among the FDA, device companies, and the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development to facilitate research and any necessary applications for device approval or clearance.

Past grant awardees have assisted in the development of devices to treat scoliosis, pediatric valvular heart disease, and projectile vomiting in newborns, among other diseases.


Source: FDA

Kids with Sickle Cell Disease More Likely to Have Physical and Developmental Health Problems

The first national estimate on the health status of children with sickle cell disease revealed that black children with sickle cell disease are more likely to have intellectual disabilities, hearing deficits, and frequent severe headaches or migraines than black children without sickle cell disease. The study by the Centers for Disease Control and Prevention (CDC), “Health Status and Healthcare Use in a National Sample of Children with Sickle Cell Disease,” was published in the American Journal of Preventive Medicine.

The study found that black children with sickle cell disease are four times more likely to have fair or poor health status, twice as likely to have recently visited a mental health professional and have received special educational or early intervention services more often compared with black children without sickle cell disease.

Sickle cell disease is a group of red blood cell disorders that is inherited, passed from parents to children. In sickle cell disease, the red blood cells become hard and sticky, and take on a sickle shape. When the C-shaped cells travel through small blood vessels, they clog the vessels and can block blood flow. In addition, the sickled cells die earlier than normal blood cells, which creates a constant shortage of red blood cells.

“In the United States, sickle cell disease is one of the most common genetic disorders; more than 20 percent of children with SCD had recently visited a health care provider such as an optometrist or an ophthalmologist, and had more than one visit to the emergency department in the past year,” said Sheree Boulet, DrPH, with CDC’s Division of Blood Disorders. “The findings of this study emphasize the importance of screening children with sickle cell disease for thinking ability, hearing, and vision problems.”

Further, despite the increased use of health care services, the data showed that more parents indicated that they could not get an appointment for their child soon enough (10.5 percent, compared to 3.9 percent of parents whose children did not have SCD), reported waiting too long in the doctor’s office (8.7 percent versus 4 percent), and could not get through to their doctor on the telephone (7.5 percent versus 1.8 percent).

“This study gives a better insight into the types of disabilities children with sickle cell disease have and can help health care providers plan comprehensive treatments for children with the disease,” said Dr. Boulet.

The study analyzed data from the 1997–2005 National Health Interview Surveys (NHIS) to describe health status and health services use among black children 0-17 years of age with SCD.  The NHIS has monitored the health of the nation since 1957; it is the principal source of information on the health of the civilian noninstitutionalized population of the United States and is one of the major data collection programs of the National Center for Health Statistics (NCHS) which is part of the Centers for Disease Control and Prevention (CDC). NHIS data on a broad range of health topics are collected through personal household interviews.

Source: Centers for Disease Control (CDC), March 23, 2010

Community-Acquired MRSA’s Increasing Prevalence in Pediatric Patients

Once considered a hospital anomaly, community-acquired infections with drug-resistant strains of the bacterium Staphylococcus aureus now turn up regularly among children hospitalized in the intensive-care unit, according to research from the Johns Hopkins Children’s Center.

The Johns Hopkins Children’s team’s findings, to be published in the April issue of the journal Emerging Infectious Diseases, underscore the benefit of screening all patients upon hospital admission and weekly screening thereafter regardless of symptoms because MRSA can be spread easily to other patients on the unit.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a virulent subset of the bacterium and impervious to the most commonly used antibiotics. Most CA-MRSA causes skin and soft-tissue infections, but in ill people or in those with weakened immune systems, it can lead to invasive, sometimes fatal, infections.

In 2007, The Johns Hopkins Hospital began screening all patients upon admission and weekly thereafter until discharge. Some states have made patient screening mandatory but the protocols vary widely from hospital to hospital and from state to state.

“MRSA has become so widespread in the community, that it’s become nearly impossible to predict which patients harbor MRSA on their body,” says lead investigator Aaron Milstone, M.D., M.H.S., a pediatric infectious disease specialist at Hopkins Children’s.

“Point-of-admission screening in combination with other preventive steps, like isolating the patient and using contact precaution, can help curb the spread of dangerous bacterial infections to other vulnerable patients.”

The new Johns Hopkins study found that 6 percent of the 1,674 children admitted to the pediatric intensive-care unit (PICU) at Hopkins Children’s between 2007 and 2008 were colonized with MRSA, meaning they carried MRSA but did not have an active infection. Of the 72 children who tested positive for MRSA, 60 percent harbored the community-acquired strain and 75 percent of all MRSA carriers had no previous history or MRSA. MRSA was more common in younger children, 3 years old on average, and among African-American children. The reasons behind the age and racial disparities in MRSA colonization remain unclear, the investigators say. Patients with MRSA had longer hospital stays (eight days) than MRSA-free patients (five days) and longer PICU stays (three days) than non-colonized patients (two days).

Eight patients who were MRSA-free upon admission became colonized with MRSA while in the PICU. Of the eight, four developed clinical signs of infection, meaning that the other four would have never been identified as MRSA carriers if the hospital was not performing weekly screenings of all patients.

The research was funded in part by the National Institutes of Health, the Thomas Wilson Sanitarium for Children in Baltimore and by the Centers for Disease Control and Prevention.

Source: John Hopkins Medicine (March 26, 2010)

Controversial Recommendation to Consider Statins for Kids with High Cholesterol

The American Academy of Pediatrics has issued new cholesterol screening and treatment recommendations for children that suggest cholesterol screening, and possible use of statins for certain children.

The policy statement, “Lipid Screening and Cardiovascular Health in Childhood,” recommends cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. It also recommends screening patients whose family history is unknown or those who have other factors for heart disease including obesity, high blood pressure or diabetes.

The AAP suggests that screening should take place after age two, but no later than age 10. The best method for testing, according to the organization’s policy statement, is a fasting lipid profile. If a child has values within the normal range, testing should be repeated in three to five years.

The American Academy of Pedatrics suggests that for children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling.

The policy statement also recommends the use of reduced-fat dairy products, such as two percent milk, for children as young as one year of age for whom overweight or obesity is a concern.

Source: American Academy of Pediatrics, July 7, 2008

Risk of Childhood Allergy and Atopic Diseases Increased by Traffic Pollution

The risk of childhood allergy and atopic diseases is increased 50% by traffic-related pollution, according to a recent study by a German research organization.

“Children living very close to a major road are likely to be exposed not only to a higher amount of traffic-derived particles and gases but also to more freshly emitted aerosols which may be more toxic,” writes Dr. Heinrich. He continued: “Our findings provide strong evidence for the adverse effects of traffic-related air pollutants on atopic diseases as well as on allergic sensitization.”

The study’s author, Joachim Heinrich, Ph.D., of the German Research Center for Environment and Health at the Institute of Epidemiology, in Munich, checked close to 2900 children aged 4, and more than 3000 children aged 6 to establish their rates of asthma and allergy in relation to longterm exposure to traffic-related pollution.

Both groups of children came from the Munich area, and their exposure to traffic pollutants was calculated on the basis opf their homes’ distance from major roads at birth, and at two, three and six years of age. The parents completed questionnaires documenting their child’s respiratory symptoms and diagnoses, and the children were evaluated for asthma, wheezing, sneezing and eczema. The children were checked for food allergies at age six, and air was tested for particulate matter nd nitrogen dioxide at 40 high traffic areas between 1999 and 2000.

Significant positive associations were found between the distance to the nearest road and incidence of asthmatic bronchitis, hay fever, eczema and allergic sensitizations. Also noted was a relationship between proximity to a road and risk of allergic sensitization—subjects living closest to major roads had an almost 50% greater risk of allergic sensitization.

In this study, it was possible to determine that economic factors were not a confounding variable in the analysis, but there was a clear difference in the children’s allergic development with relation to their proximity to a road.

Source: American Journal of Respiratory and Critical Care Medicine, June, 2008 (2nd ed)

Risk of Type 1 Diabetes in Children Related to Vitamin D and Sun

Researchers have found that the risk of Type 1 diabetes in children may be strongly associated with Vitamin D and exposure to sunshine.

Low incidence of type 1 diabetes was noted in people living in equatorial regions, while higher incidence was noted in populations at higher latitudes where sunlight was scarcer.

Photosynthesis of vitamin D3 is set in motion by ultraviolet exposure, while this form of vitamin D is also available through diet and supplements. "This is the first study, to our knowledge, to show that higher serum levels of vitamin D are associated with reduced incidence rates of type 1 diabetes worldwide," said Cedric F. Garland, Dr. P.H., professor of Family and Preventive Medicine in the UCSD School of Medicine, and a member of the Moores UCSD Cancer Center.

About 1.5 million Americans cope with type 12 diabetes every day, and type 1 diabetes ranks second only to asthma as the most chronic disease among children. Type 1 diabetes is diagnosed in some 15,000 Americans each year, and causes blindness and kidney failure in youth and middle age.

"This research suggests that childhood type 1 diabetes may be preventable with a modest intake of vitamin D3 (1000 IU/day) for children, ideally with 5 to 10 minutes of sunlight around noontime, when good weather allows," said Garland. "Infants less than a year old should not be given more than 400 IU per day without consulting a doctor. Hats and dark glasses are a good idea to wear when in the sun at any age, and can be used if the child will tolerate them."

Even after allowing for the fact that equatorial regions will have lower per capita healthcare expenditures than more developed countries, the association of UVB irradiance to incidence of type 1 diabetes remained strong. The researchers created a graph with a vertical axis for diabetes incidence rates, and a horizontal axis for latitude. The latitudes range from -60 for the southern hemisphere, to zero for the equator, to +70 for the northern hemisphere. They then plotted incidence rates for 51 regions according to latitude. The resulting chart was a parabolic curve that looks like a smile.

In the paper the researchers call for public health action to address widespread vitamin D inadequacy in U.S. children.

"This study presents strong epidemiological evidence to suggest that we may be able to prevent new cases of type 1 diabetes," said Garland. "By preventing this disease, we would prevent its many devastating consequences."

The study was published June 5, 2008 in the online version of the scientific journal Diabetologia.

Early Amino Acids Speed Weight Gain in Premature Babies

Providing amino acids to premature babies immediately after birth resulted in significant weight gain when compared with preterm babies receiving amino acids later, according to a study conducted by Nationwide Children’s Hospital.

"Many of our premature infants are born before the last trimester, when significant nutrition accumulation occurs, as well as a lot of growth," said the study’s lead author, Christina Valentine, MD, MS, RD, medical director for neonatal nutrition services at Nationwide Children’s Hospital and a fellow at The Ohio State University Medical Center. "Our findings suggest that the first 24 hours of life is a crucial time for the administration of nutrition."

The study included 440 preterm infants born between 2004 and 2006, weighing less than 1500 grams at birth. 308 infants born between 2005 and 2006 were given amino acids within 24 hours of delivery, and compared with 132 preterm infants fromm2004 who were not given the amino acid diet. Those born in 2005 and 2006 weighed significantly more at discharge – 2,342 grams -than those born in 2004, who had a mean weight of 2,242 grams.

"Preterm infants often face acute diseases immediately upon entering the world, so in years past, their nutrition has typically gone on the back burner," said Stephen Welty, MD, chief of neonatology at Nationwide Children’s Hospital and a faculty member at The Ohio State University College of Medicine. "The more we learn, the more we are realizing that nutrition should probably go on the front burner, because the evidence suggests nutrition may play a vital role in improving their overall health, even in the first few days of life."

Neonatologists at Nationwide Children’s Hospital have developed a collaborative approach to providing early, aggressive nutrition for premature infants. The neonatal nutrition team, directed by Valentine, is comprised of neonatal dieticians, lactation consultants, peer counselors, pharmacists and a diet technician. The team assesses infants on an individual basis to determine their unique nutritional needs and prescribe individualized action plans, aimed at increasing weight and warding off diseases commonly associated with preterm birth.

Source: Nationwide Children’s Hospital

Children Still At Risk from Lead Poisoning, Despite Programs Promoting Cleaning and Home Repair

A review of studies shows that children are still at risk of lead poisoning, despite attempts to encourage home cleaning and repairs, and parental awareness.

Lead author Dr. Berlinda Yeoh, a pediatrician at Sydney Childrens’ Hospital in New south Wales, Australia, says of these attempts that "none that have been tried so far have been proven to be effective." The most common cause of lead poisoning in children is ingestion of dust from old lead paint, and Dr. Yeoh cited lead poisoning as an important health issue for children. It can, she said, contribute to behavior and growth problems, anemia, kidney damage, and other physical, cognitive and behavioral impairment.

Although the sale of lead paint in the United States was prohibited as long ago as 1978 children today can still ingest paint from peeling walls, broken plaster or old painted window sills. 12 U.S. studies, encompassing 2239 children, were examined, and analyzed 2 types of parental interventions—educational and environmental. Educational intervention taught awareness of lead poisoning and methods of preventing dust and lead exposure in the home; environmental intervention suggested making repairs, cleaning and painting.

The Cochrane Library carried the review, and the reviewers’ findings that educational programs for parents had no effect on children’s blood lead levels, which was also the case for environmental programs. Soil abatement, or the replacement of lead-contaminated soil around the home, was also analyzed and 2 studies showed that this significantly reduced childrens’ blood lead levels, although insufficient data prevented recommending these practices as effective. Even studies that combined both educational and environmental interventions failed to reduce children’s blood lead levels.

Dr. Yeoh pointed to other sources of lead exposure—at day care or relatives’ home, for example—which might make home dust removal programs ineffective.

A further reason might be lack of time to be cleaning thoroughly, said Dr. Yeoh. Based on these results, "it is difficult to support the use of the interventions examined in this review as a general population health measure, given their cost and the lack of data showing positive reductions in blood lead levels," the authors said.

Susan Buchanan, M.D., a clinical assistant professor at the University of Illinois at Chicago School of Public Health, called the review "a very thorough evaluation of current literature. It takes so little lead dust to poison a child that it doesn’t matter how clean your house is, your child is still going to have exposure to lead dust," she said.

"As adults, our neurological systems are somewhat immune to the dramatic effects of lead," Buchanan said. However, very young children often put objects in their mouths—increasing their ingestion of house dust and dirt—that in turn affects their developing neurological systems, she said.

"We have to use the knowledge we have—there is lead in dust, so as much dust removal as possible should still be recommended," she said. However, to "continue screening is critical because if high blood lead levels are caught, then health department inspectors can be used to point out obvious sources of lead in the home," Buchanan said.

The review noted that a coauthor, Bruce Lanphear, was an investigator in two of the studies included in this review.

Source: Health Behavior News Service