David Baxter PhD
Late Founder
Hit or Myth
TodaysParent.com
John Hoffman
Ever wondered if those things your mother told you were true? Here's the real deal on ten common ideas about children's health
Myth 1: Your child can catch a cold from being too cold.
Viruses, not air temperature, cause colds. Researchers have subjected hapless (and hopefully well paid) participants to ignoble conditions such as sitting for hours in cold rooms or with their feet in buckets of ice water. And if there is a connection between being cold and getting one, researchers haven’t found it. In any case, the most important factor by far is being exposed to a cold germ.
What we know: People do get more colds in the colder months. However, no one’s been able to prove why that is. A common explanation is the crowding theory: In cold weather children spend more time indoors in close proximity to each other, passing new types of germs back and forth. But there is no irrefutable evidence stating this is why winter brings on the colds.
Jack Gwaltney, an infectious diseases expert at the University of Virginia and co-director of the Web site commoncold.org, says the annual increase in colds coincides not with cold weather, but with the resumption of school. “When children reassemble in the fall, they start bringing colds home and this is a major contributor to the annual epidemic of rhino-viruses,” says Gwaltney.
Bottom line: It’s all about the germs. According to Gwaltney, “It’s clear the major reservoir for the common cold is the noses of children.”
Myth 2: Sugar makes children hyperactive.
The legions of educators who insist that sugar makes kids hyper after Halloween won’t like this answer.
What we know: Ten years ago Mark Wolraich, an Oklahoma developmental-behavioural paediatrician, did a study in which 48 children were given three different, strictly controlled diets. For three weeks the diet was high in sugar and for the other two three-week periods, sugar was replaced by saccharine and aspartame respectively. Parents reported no difference in children’s behaviour on any of the diets. Wolraich notes, “We also checked to see if there might be effects for individual children that hadn’t shown up in the group results. We didn’t find that either.”
Two years later, Wolraich and his colleagues published a meta-analysis of 23 studies. Most of these involved “challenge” tests, in which researchers gave children sugar in a lab setting and observed them for behaviour changes. “Once again, we found no effect of sugar on behaviour,” says Wolraich.
Meanwhile, in a 1994 American study, children believed to be sensitive to sugar were given food containing artificial sweetener in the presence of their parents. Half the parents were told their children were getting sugar. Those parents rated their kids’ behaviour as worse than the parents who were told their children were getting artificial sweetener.
Bottom line: Food sensitivities can cause behavioural changes in some children, at least enough to warrant further research, according to Wolraich. But he feels the idea that sugar causes hyperactive behaviour has been pretty much put to rest.
Myth 3: Your baby needs a bath every day.
Her face, hands and bottom need to be washed, but she doesn’t necessarily need a daily soak.
What we know: We checked three baby books written by paediatricians, and all persuaded parents not to bathe babies every day. Some doctors advise against full immersion baths until the umbilical cord stump has healed, but others think it doesn’t matter. Check with yours.
Bottom line: Frequent baby bathing is “a cosmetic question” as opposed to a health/hygiene issue, says paediatrician Elmer Grossman in his book Everyday Pediatrics for Parents. It’s also a matter of baby’s comfort level. If giving her a bath becomes an enjoyable bonding experience for the parents and baby, and it doesn’t seem to dry her skin, then there’s no reason to forgo this daily ritual.
Myth 4: Teething can cause fever and diarrhea.
Sometimes, but it depends what you mean by fever and diarrhea. Parents and some health care professionals have believed this for years, but experts tend to, ahem, pooh-pooh the idea.
What we know: One study, published in Pediatrics in 2000, followed 125 Cleveland children from their fourth month to their first birthday. Parents took temperatures twice a day, checked for tooth eruptions and recorded various other symptoms, including loose stools. The results showed no increase in reports of loose stools on a “tooth day” (four days before a tooth emerged and three days after), but did show a trend towards mildly elevated body temperature. An Australian study, which took the day of the tooth eruption and the five preceding days as the critical period, found that loose stools were mildly associated with teething, but not elevated temperature.
Bottom line: Teething itself is unlikely to cause anything more than slightly elevated body temperature and loose stools (as opposed to medically significant fever and diarrhea). If your baby seems ill while he’s cutting teeth, use the same criteria you would if he weren’t teething — monitor his condition and consult a physician if you’re concerned.
Myth 5: If a fever can’t be brought down by acetaminophen, it must be serious.
“Just because a fever doesn’t come down with adequate doses of acetaminophen doesn’t mean the cause of the fever is sinister,” says Toronto paediatrician Jack Newman. “By the same token, if a fever does come down with acetaminophen, it doesn’t mean the cause is benign.” Newman adds that it’s not necessary to bring down a high fever to prevent febrile convulsions. They are generally believed (but not proven) to be caused by a rapid spike in temperature rather than a high temperature.
What we know: Fever is a non-specific symptom: an indicator that your child is fighting an infection. If your child has a fever, you need to find out more about the infection, not more about the fever.
Bottom line: If you “treat the child not the fever,” as current medical wisdom suggests, then how sick your child seems and other symptoms he may have (headache, vomiting, pain, sore throat, lethargy, etc.) are usually more significant than the fever itself. Guidelines for when to call the doctor vary, however. The Canadian Paediatric Society recommends consulting a doctor for any fever (38°C armpit or oral, 38.5°C rectal) in babies under six months old. The thinking here is that young babies can get sick quickly. However, most of the time, the illness will prove to be minor.
Myth 6: If you don’t get the whole sliver out, it will cause infection.
Parents used to go to heroic (and painful) lengths to excise every iota of a sliver for fear that remaining fragments would fester. This is seldom the case, says paediatric ER physician Patricia Wren of the IWK Health Centre in Halifax. “A sliver will usually work its way out without serious infection,” she says.
What we know: The body recognizes a sliver as a foreign object and tries to reject it via an inflammatory response, causing redness, swelling and, usually, a small, hard pustule: a localized infection (although usually not painful) that pushes the foreign material to the surface, eventually making it easier to find and remove. Sometimes the sliver pops out when a doctor breaks the pustule (don’t try this at home, folks, says Wren). Often it happens without intervention.
Bottom line: “Ideally, you’d like to get it out, and if it’s really hurting the child you need to remove it,” says Wren. “But if you can’t easily feel, see or get at the sliver, it can be a long, painful and frustrating experience.” Keep the wound clean, put a bandage on it, try soaking it perhaps, and wait until the material works its way to the surface.
Myth 7: It’s better to get chickenpox when you’re young.
This one’s true — with the exception of babies less than three months of age who are at higher risk for severe symptoms and complications.
What we know: A recent French study showed that the incidence of hospitalization and death from chickenpox increased dramatically with age. “It’s clearly riskier to get chickenpox as an adult,” says Tim Mailman, infectious diseases specialist at IWK Health Centre in Halifax. The disease also tends to be more severe — with more lesions and greater risk of complications — in adolescents than in younger children.
If you escape chickenpox as a child, might you get it as an adult in the form of shingles? No. In order to get shingles you have to be exposed to chickenpox first. Mailman explains: “Varicella zoster, the virus that causes both chickenpox and shingles, is a herpes virus, and all herpes viruses have the ability to lie dormant in the body. After recovery from chickenpox, the virus can remain in the body for years and then come out of hiding to cause shingles in an adult.”
Bottom line: Now that there’s a vaccine for chickenpox, it’s no longer necessary to get it at all, says Mailman. The vaccine, though not yet part of the routine immunization schedule, is recommended for children over the age of 12 months who have never had chickenpox. Children one to 12 need one dose. Teens 13 years and older need two doses, four weeks apart.
Myth 8: Swimming immediately after eating is dangerous.
Allowing junior to do five lengths of front crawl after scarfing down a major meal is probably inadvisable and may be uncomfortable, as would just about any strenuous activity. However, there is no evidence to suggest that feasting and swimming can lead to drowning, as many of us were told when we were kids.
What we know: The Canadian Red Cross analyzed records of all Canadian drowning deaths between 1991 to 2000. Nowhere in the report does it cite going in the water after eating as a risk factor.
Bottom line: In child drownings the real risks are:
o lack of supervision (half of infants and toddlers who drowned were alone);
o private pools without self-latching or self-closing gates;
o and not wearing life jackets in boats.
Myth 9: Sitting too close to the TV is bad for your child’s eyes.
According to various eye care experts, including the Canadian Ophthalmological Society, this is not true.
What we know: Children can focus up close without eye strain more easily than adults, which might explain their penchant for sitting close to the TV.
Bottom line: While sitting nose to screen won’t hurt your child’s eyes, if the practice persists, it could be a sign she needs her vision checked.
Myth 10: if kids go short on sleep, they are more likely to get sick.
We don’t know this for sure, but we do know that not getting enough sleep is bad for children in other ways. Sleep deprivation probably affects immune function in some way, but there simply aren’t enough data to allow even a guess at how much loss of sleep makes a significant difference.
What we know: Research has shown that serious sleep deprivation compromises the immune system of rats. In humans, it alters the normal patterns of endocrine and immune function. However, most studies involve a level of sleep disturbance that ordinary people seldom experience.
There is better evidence about the relationship between lack of sleep and poor school performance and also increased risk of injury, according to Harvey Moldofsky, medical director of the Sleep Disorders Clinic of the Centre for Sleep Chronobiology in Toronto. An Italian study, published in Pediatrics in 2001, found a link between not getting enough sleep (or not having had a nap) and increased risk of injury in preschoolers, especially boys.
Bottom line: Regardless of how lack of sleep affects immune function, kids are not at their best when they haven’t slept well. Also, experts believe that sleep disorders in children tend to go undiagnosed and untreated. If your child has an ongoing sleep problem, ask your doctor to refer you to a specialist.
TodaysParent.com
John Hoffman
Ever wondered if those things your mother told you were true? Here's the real deal on ten common ideas about children's health
Myth 1: Your child can catch a cold from being too cold.
Viruses, not air temperature, cause colds. Researchers have subjected hapless (and hopefully well paid) participants to ignoble conditions such as sitting for hours in cold rooms or with their feet in buckets of ice water. And if there is a connection between being cold and getting one, researchers haven’t found it. In any case, the most important factor by far is being exposed to a cold germ.
What we know: People do get more colds in the colder months. However, no one’s been able to prove why that is. A common explanation is the crowding theory: In cold weather children spend more time indoors in close proximity to each other, passing new types of germs back and forth. But there is no irrefutable evidence stating this is why winter brings on the colds.
Jack Gwaltney, an infectious diseases expert at the University of Virginia and co-director of the Web site commoncold.org, says the annual increase in colds coincides not with cold weather, but with the resumption of school. “When children reassemble in the fall, they start bringing colds home and this is a major contributor to the annual epidemic of rhino-viruses,” says Gwaltney.
Bottom line: It’s all about the germs. According to Gwaltney, “It’s clear the major reservoir for the common cold is the noses of children.”
Myth 2: Sugar makes children hyperactive.
The legions of educators who insist that sugar makes kids hyper after Halloween won’t like this answer.
What we know: Ten years ago Mark Wolraich, an Oklahoma developmental-behavioural paediatrician, did a study in which 48 children were given three different, strictly controlled diets. For three weeks the diet was high in sugar and for the other two three-week periods, sugar was replaced by saccharine and aspartame respectively. Parents reported no difference in children’s behaviour on any of the diets. Wolraich notes, “We also checked to see if there might be effects for individual children that hadn’t shown up in the group results. We didn’t find that either.”
Two years later, Wolraich and his colleagues published a meta-analysis of 23 studies. Most of these involved “challenge” tests, in which researchers gave children sugar in a lab setting and observed them for behaviour changes. “Once again, we found no effect of sugar on behaviour,” says Wolraich.
Meanwhile, in a 1994 American study, children believed to be sensitive to sugar were given food containing artificial sweetener in the presence of their parents. Half the parents were told their children were getting sugar. Those parents rated their kids’ behaviour as worse than the parents who were told their children were getting artificial sweetener.
Bottom line: Food sensitivities can cause behavioural changes in some children, at least enough to warrant further research, according to Wolraich. But he feels the idea that sugar causes hyperactive behaviour has been pretty much put to rest.
Myth 3: Your baby needs a bath every day.
Her face, hands and bottom need to be washed, but she doesn’t necessarily need a daily soak.
What we know: We checked three baby books written by paediatricians, and all persuaded parents not to bathe babies every day. Some doctors advise against full immersion baths until the umbilical cord stump has healed, but others think it doesn’t matter. Check with yours.
Bottom line: Frequent baby bathing is “a cosmetic question” as opposed to a health/hygiene issue, says paediatrician Elmer Grossman in his book Everyday Pediatrics for Parents. It’s also a matter of baby’s comfort level. If giving her a bath becomes an enjoyable bonding experience for the parents and baby, and it doesn’t seem to dry her skin, then there’s no reason to forgo this daily ritual.
Myth 4: Teething can cause fever and diarrhea.
Sometimes, but it depends what you mean by fever and diarrhea. Parents and some health care professionals have believed this for years, but experts tend to, ahem, pooh-pooh the idea.
What we know: One study, published in Pediatrics in 2000, followed 125 Cleveland children from their fourth month to their first birthday. Parents took temperatures twice a day, checked for tooth eruptions and recorded various other symptoms, including loose stools. The results showed no increase in reports of loose stools on a “tooth day” (four days before a tooth emerged and three days after), but did show a trend towards mildly elevated body temperature. An Australian study, which took the day of the tooth eruption and the five preceding days as the critical period, found that loose stools were mildly associated with teething, but not elevated temperature.
Bottom line: Teething itself is unlikely to cause anything more than slightly elevated body temperature and loose stools (as opposed to medically significant fever and diarrhea). If your baby seems ill while he’s cutting teeth, use the same criteria you would if he weren’t teething — monitor his condition and consult a physician if you’re concerned.
Myth 5: If a fever can’t be brought down by acetaminophen, it must be serious.
“Just because a fever doesn’t come down with adequate doses of acetaminophen doesn’t mean the cause of the fever is sinister,” says Toronto paediatrician Jack Newman. “By the same token, if a fever does come down with acetaminophen, it doesn’t mean the cause is benign.” Newman adds that it’s not necessary to bring down a high fever to prevent febrile convulsions. They are generally believed (but not proven) to be caused by a rapid spike in temperature rather than a high temperature.
What we know: Fever is a non-specific symptom: an indicator that your child is fighting an infection. If your child has a fever, you need to find out more about the infection, not more about the fever.
Bottom line: If you “treat the child not the fever,” as current medical wisdom suggests, then how sick your child seems and other symptoms he may have (headache, vomiting, pain, sore throat, lethargy, etc.) are usually more significant than the fever itself. Guidelines for when to call the doctor vary, however. The Canadian Paediatric Society recommends consulting a doctor for any fever (38°C armpit or oral, 38.5°C rectal) in babies under six months old. The thinking here is that young babies can get sick quickly. However, most of the time, the illness will prove to be minor.
Myth 6: If you don’t get the whole sliver out, it will cause infection.
Parents used to go to heroic (and painful) lengths to excise every iota of a sliver for fear that remaining fragments would fester. This is seldom the case, says paediatric ER physician Patricia Wren of the IWK Health Centre in Halifax. “A sliver will usually work its way out without serious infection,” she says.
What we know: The body recognizes a sliver as a foreign object and tries to reject it via an inflammatory response, causing redness, swelling and, usually, a small, hard pustule: a localized infection (although usually not painful) that pushes the foreign material to the surface, eventually making it easier to find and remove. Sometimes the sliver pops out when a doctor breaks the pustule (don’t try this at home, folks, says Wren). Often it happens without intervention.
Bottom line: “Ideally, you’d like to get it out, and if it’s really hurting the child you need to remove it,” says Wren. “But if you can’t easily feel, see or get at the sliver, it can be a long, painful and frustrating experience.” Keep the wound clean, put a bandage on it, try soaking it perhaps, and wait until the material works its way to the surface.
Myth 7: It’s better to get chickenpox when you’re young.
This one’s true — with the exception of babies less than three months of age who are at higher risk for severe symptoms and complications.
What we know: A recent French study showed that the incidence of hospitalization and death from chickenpox increased dramatically with age. “It’s clearly riskier to get chickenpox as an adult,” says Tim Mailman, infectious diseases specialist at IWK Health Centre in Halifax. The disease also tends to be more severe — with more lesions and greater risk of complications — in adolescents than in younger children.
If you escape chickenpox as a child, might you get it as an adult in the form of shingles? No. In order to get shingles you have to be exposed to chickenpox first. Mailman explains: “Varicella zoster, the virus that causes both chickenpox and shingles, is a herpes virus, and all herpes viruses have the ability to lie dormant in the body. After recovery from chickenpox, the virus can remain in the body for years and then come out of hiding to cause shingles in an adult.”
Bottom line: Now that there’s a vaccine for chickenpox, it’s no longer necessary to get it at all, says Mailman. The vaccine, though not yet part of the routine immunization schedule, is recommended for children over the age of 12 months who have never had chickenpox. Children one to 12 need one dose. Teens 13 years and older need two doses, four weeks apart.
Myth 8: Swimming immediately after eating is dangerous.
Allowing junior to do five lengths of front crawl after scarfing down a major meal is probably inadvisable and may be uncomfortable, as would just about any strenuous activity. However, there is no evidence to suggest that feasting and swimming can lead to drowning, as many of us were told when we were kids.
What we know: The Canadian Red Cross analyzed records of all Canadian drowning deaths between 1991 to 2000. Nowhere in the report does it cite going in the water after eating as a risk factor.
Bottom line: In child drownings the real risks are:
o lack of supervision (half of infants and toddlers who drowned were alone);
o private pools without self-latching or self-closing gates;
o and not wearing life jackets in boats.
Myth 9: Sitting too close to the TV is bad for your child’s eyes.
According to various eye care experts, including the Canadian Ophthalmological Society, this is not true.
What we know: Children can focus up close without eye strain more easily than adults, which might explain their penchant for sitting close to the TV.
Bottom line: While sitting nose to screen won’t hurt your child’s eyes, if the practice persists, it could be a sign she needs her vision checked.
Myth 10: if kids go short on sleep, they are more likely to get sick.
We don’t know this for sure, but we do know that not getting enough sleep is bad for children in other ways. Sleep deprivation probably affects immune function in some way, but there simply aren’t enough data to allow even a guess at how much loss of sleep makes a significant difference.
What we know: Research has shown that serious sleep deprivation compromises the immune system of rats. In humans, it alters the normal patterns of endocrine and immune function. However, most studies involve a level of sleep disturbance that ordinary people seldom experience.
There is better evidence about the relationship between lack of sleep and poor school performance and also increased risk of injury, according to Harvey Moldofsky, medical director of the Sleep Disorders Clinic of the Centre for Sleep Chronobiology in Toronto. An Italian study, published in Pediatrics in 2001, found a link between not getting enough sleep (or not having had a nap) and increased risk of injury in preschoolers, especially boys.
Bottom line: Regardless of how lack of sleep affects immune function, kids are not at their best when they haven’t slept well. Also, experts believe that sleep disorders in children tend to go undiagnosed and untreated. If your child has an ongoing sleep problem, ask your doctor to refer you to a specialist.
