Following testing, the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention have concluded that powdered baby formula Enfamil did not cause recent Cronobacter sakazakii bacterial infections in which two infants died and two others were sickened. 

Although Mead Johnson Nutrition's product, Enfamil, appears to be cleared for the time being, questions remain about powdered baby formula in general. Walmart and several other grocery distribution companies pulled the powdered formula from their shelves over the Christmas and New Year's holidays.

In addition, CDC announced its conclusion that "powdered baby formula is not sterile." Scientific experts have said there are "no adequate methods to prevent bacteria from creeping into the baby formula." http://www.cbsnews.com/8301-504763_162-57351494-10391704/enfamil-infant-formula-cleared-in-kids-bacterial-infections/  

The World Health Organization recommends that parents who prepare infant formula should wash their hands with soap and water, sterilize all feeding equipment in hot, soapy water, and prepare only enough formula for one feeding at a time.

Childsafetyblog encourages new moms to focus on the basics of caring for infants:

Watch newborns carefully, making sure they, their areas and their food stuffs are kept clean

Make sure your hands are clean when you handle your child

If you believe there are negative changes in your newborn or there are signs of irritability, jaundice, unstable body temperature or difficulty eating and breathing--all symptoms of Cronobacter infection--call your doctor immediately, go to the Emergency Room of your local hospital, or call 911.

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A third child has become ill due to a rare bacterial infection called Cronobacter sakazakii, and it is not yet known whether this is due to consumption of infant formula. ChildSafetyBlog.org readers will recall the sad news of last week and our posting about the 10-day old infant who had been given the formula, Enfamil Premium Newborn Powdered formula, contracted a bacterial infection called Cronobacter sakazakii, and died.

During the Christmas holidays, many stores besides Walmart -- including Kroger's, Safeway, Walgreen, and SuperValu, all pulled the 12.5 oz. containers of Lot No. ZP1K7G Enfamil Premium Newborn Powdered formula from their shelves. Mead Johnson Nutrition, the manufacturer, didn't pull the product from its distributors or retailers, but began testing their products for the bacterium.

Now, a third child has come down with the rare bacterial infection of which the U.S. Centers for Disease Control and Prevention (CDC) says, "Between four and six cases of cronobacter are reported in a typical year. So far, 10 cases have been reported in 2011 which is still within a normal range." http://blogs.webmd.com/breaking-news/2011/12/third-baby-tests-positive-for-cronobacter.html

As of December 23, 2011, Mead Johnson Nutrition said all batches of Enfamil were tested for Cronobacter bacteria before they were shipped, and if an ingredient or batch are found to contain the bacterium, they are rejected. They also said "the lot used by the newborn's family did not test positive for Cronobacter when the company tested it." http://www.businessweek.com/ap/financialnews/D9RQDD881.htm

Mead Johnson Nutrition has been working with the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) to test the formula. According to a statement from Mead Johnson, no traces of cronobacter have been found.

Also according to a posting on WebMD of December 28, 2011, "Although the babies in Illinois and Oklahoma had been given infant formula, it's not yet known whether the formula was the source of the infection, according to a CDC spokesperson. The baby in Oklahoma was not fed Enfamil, and the baby in Illinois reportedly was fed several different types of formula. The CDC reports that state health authorities are currently testing the formulas and the water they were mixed with to determine the source of the infection and to uncover any possible links between the three cases. So far, no direct connections have been found."  http://blogs.webmd.com/breaking-news/2011/12/third-baby-tests-positive-for-cronobacter.html

ChildSafetyBlog.org is following this news and will provide updates as we learn them.

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BPA Revisited

It's not as though people hadn't begun to suspect there might be something negative linked to the presence of BPA in plastic water bottles and can linings. The Department of Health and Human Services' (DHHS) Safety tips website has an entire page devoted to BPA noting that "BPA is a chemical that has been used for more than 40 years in the manufacture of many hard plastic food containers such as baby bottles and reusable cups and the lining of metal food and beverage cans, including canned liquid infant formula. Trace amounts of BPA can be found in some foods packaged in these containers." http://www.hhs.gov/safety/bpa/

There have been some hints along the way that human and animal exposure to BPA in varying degrees might not be too good. Previously performed studies have linked the chemical BPA to asthma in young children. The Centers for Disease Control and Prevention (CDC) have compiled data on BPA, otherwise known as bisphenol A, exposure, which show that nearly all Americans have a measurable amount of the chemical in their systems.  http://healthland.time.com/2011/10/24/bpa-exposure-in-pregnancy-may-affect-behavior-in-girls/ 

Findings of a recent scientific study published in the journal, Pediatrics, this week highlight questions about the use of BPA by pregnant women and BPA's effects on their young children. The Time Health™ website, a division of Time Magazine, noted this study "promise[s] to heat up" the debate over the safety of the use of BPA.  http://healthland.time.com/2011/10/24/bpa-exposure-in-pregnancy-may-affect-behavior-in-girls/#ixzz1c5RPy6j6

The study, performed by research fellow Joe Braun of the Harvard School for Public Health, found that among "a group of 244 moms with higher BPA levels during pregnancy and their three year olds" (whose BPA levels were also measured), "moms with higher BPA levels were more likely to have children who were aggressive, anxious and hyperactive and showed poor emotional control, compared with moms with lower levels of BPA." The effect was more striking in girls than in boys. "Girls in the study were more than twice as likely as boys to show anxiety and depression if their mothers had been exposed to BPA." The study points to the importance of the relationship of healthfulness in pregnancy to early brain development.  Braun stated, "It's possible that the brain is more vulnerable to the effects of BPA during certain parts of pregnancy, such as the early stages, and not as vulnerable later." 

Certainly, the results of this study are daunting and something pregnant women should pay attention to, but can we always tell if BPA is in our water bottles or cans?  HHS says that we should note that plastic containers have recycle codes on the bottom.  "In general, plastics that are marked with recycle codes 1, 2, 4, 5, and 6 are very unlikely to contain BPA.  Some, but not all, plastics that are marked with recycle codes 3 or 7 may be made with BPA."  And to minimize exposure, parents and caregivers can do the following:

• Do not put very hot or boiling liquid that you intend to consume in plastic containers made with BPA.  BPA levels rise in food when containers/products made with the chemical are heated and come in contact with the food.
• Discard all bottles with scratches, as these may harbor bacteria and, if BPA-containing, lead to greater release of BPA.

Of course, these suggestions are only good if you can identify the bottles and cans that contain BPA.  If you can't tell, we suggest that you stick to glass containers of baby foods and/or containers you know do not contain BPA--or containers to use to feed baby, (such as glass or stainless steel or china), that can be washed with hot, soapy water and rinsed before and after using.

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CNN's American Morning's (Christine Romans') sound bite on a possible link between pregnant mothers taking antidepressants giving birth to children with autism spectrum disorder (ASD), set off some loud alarm bells in many homes throughout the country.  This morning, CNN's Romans synopsized a study the results of which signal the possibility that pregnant women taking antidepressants which are SSRIs (selective serotonin reuptake inhibitors), such as Prozac, Zoloft and Celexa, may give birth to children with autism.

The lead author of this study published in the Archives of General Psychiatry, Lisa Croen, PhD, director of autism research at Kaiser Permanente Northern California, noted "This is the first study of its kind to look at the association, and the findings have to be interpreted with a lot of caution." She also noted that causality could not be definitely attributed using the results of a single study.

The study suggests that use of antidepressants during early pregnancy may pose a greater risk of ASD to the child.  In this study of less than 300 children who have ASD, children exposed to the drugs during the first trimester were nearly four times more likely to develop an ASD, compared with unexposed children. http://www.cnn.com/2011/HEALTH/07/04/antidepressant.pregnancy.autism.risk/

The study's researchers found that "any exposure to the drugs in the womb increased the risk of ASD diagnosis 2.2-fold, while first-trimester exposure increased the risk 3.8-fold."  Slightly more than 2 percent of all autism cases among children born in the late 1990s could be attributed to SSRI exposure, Croen and her colleagues estimate."  And, she says, this percentage could be higher today, "because SSRI use during pregnancy has become more common." A study in 2005 study found that 6.5 percent of pregnant women were taking SSRIs.

While physicians aren't quite ready to tell pregnant mothers to stop using antidepressants, the results of this study should be noted and definitely will spawn further research into the possible link between the use of antidepressants by pregnant women and ASD in their offspring.

Childsafetyblog.org will continue to keep its blog followers posted on the results of additional  research in this possible link between antidepressants and ASD.

--"Kids should not have energy drinks!" http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/26763?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=323650

I don't know about you folks, but I am so relieved. Everyone interested in child safety and health has been awaiting the report by the American Academy of Pediatrics with baited breath!  And the APA says, "Kids shouldn't have energy drinks at all and only need sports drinks occasionally." Phew, I was beginning to wonder. 

For years, doctors have warned parents and caregivers about giving kids too much sugar in candy, snacks, ice cream, sodas, sweetened juices and other foods; the evils of high fructose corn syrup and caffeine have been preached to us almost incessantly by nutrition activists--and then into the marketplace--as if in defiance of everything we've been taught--come energy drinks for kids.  You could have knocked me over with a feather! Caffeine and other stimulants contained in energy drinks "have no place in the diet of children and adolescents," cautioned Marcie Beth Schneider, MD, of Greenwich Adolescent Medicine in Greenwich, Conn., and colleagues.  (I'm thinking we should recommend Marcie Beth for something in the order of sainthood.)

The APA says, "Frequently downing Gatorade, Powerade and other sports drinks can substantially boost risk of weight problems for the average child." And here in the U.S. the problems associated with childhood obesity have increased in the past decade in geometric proportions! (APA says the exception to that statement is youth athletes who participate in regular, high-intensity sports and may benefit from electrolyte-replacing drinks following sports activity.) 

But what the APA says parents really need to be aware of is that "sports and energy drinks are being marketed to kids for a wide variety of inappropriate uses." Energy drink advertisements target kids' desire to excel in sports, suggesting better athletic performance and replacement of fluid and electrolytes lost in sweat, as well as a boosting energy, enhancing concentration and mental alertness." Nice huh... and meanwhile as sports enthusiasts, parents are concerned about a trend in adult sports figures (who shall remain nameless) consuming performance enhancing drugs in everything from bicycling competitions to baseball... Wouldn't sanctioning energy drinks be kind of like programming our kids to do the same when they become adult sports enthusiasts or athletes? 

One survey cited by the APA report says that "56.4% of U.S. kids drink sports beverages and 42.3% consume energy drinks."  To me, those are startling figures!  And while sports drinks may contain around 70 calories per serving, energy drinks may contain as much as 270 calories per serving... whoa Nellie!  And the latter may contain--are you ready--stimulants like caffeine, guarana, taurine, ginseng, L-carnitine, and creatine.  This raises a whole host of issues in my book.

So, parents, if you want more information on the APA report, go to: Schneider MB, et al "Clinical report-Sports drinks and energy drinks for children and adolescents: Are they appropriate?" Pediatrics 2011; 127: 1182-1189.   But with this report, we can all breathe a sigh of relief, that water is still the best choice of drink for our kids!

Recently, in an article for Bottom Line's Daily Health News (May 19, 2011), the work of Dr. David Pimentel, professor emeritus of entomology at Cornell University, Ithaca, New York,[1] was referenced regarding the increasing concern about pesticides in the environment and what concentrations of pesticides over time do to adults and children. There is serious concern about the effects of exposure to pesticides in young children, as children are growing! 

While it's been almost 40 years since the 1972 ban by the U.S. Environmental Protection Agency (EPA) of the regular use of the pesticide DDT (Its chemical name is 1,1,1-trichloro-2,2-bis-(p-chlorophenyl) ethane.), DDT is still used in other countries to combat insects which carry diseases like yellow fever and malaria. Yet, since 1972, pesticide use in the U.S. has not declined but increased.  In fact, about 70,000 chemicals are in use today in different pesticides and herbicides and some are known carcinogens.

There is new research linking pesticides to diseases and unhealthy conditions other than cancer, such as Parkinson's Disease, dementia and infertility in men. In "Pesticides and Risk of Parkinson's Disease"(J. Firestone et al, American Medical Association, 2005), the authors find pesticide exposures are suspected risk factors for Parkinsonism.  In children, however, the problem of pesticides, Dr. Pimentel says, is "amplified" compared with adults, as children actually consume more food in proportion to their body weight than adults, so they receive a proportionally greater amount of food exposed to pesticides or herbicides. A study in children found that the body fluids of "children eating a variety of conventional foods contained markers for organophosphates, a lethal pesticides used to disable the nervous system of pests."[2] When the same children's diets were changed "to only organic foods, the chemicals disappeared from their bodies within 36 hours."[3] While pesticides have been tagged as contributors to the increased incidence of neurodegenerative diseases, they continue to be used and their use continues to be scrutinized by scientists in the U.S. Food and Drug Administration (FDA), the EPA and the U.S. Department of Agriculture, as well as by university laboratory scientists like Dr. Pimentel.

While newer pesticides and herbicides on the market are used in lesser concentrations than DDT was used, some of the newer pesticides and herbicides are more toxic, such as paraquat and rotenone.  So what should parents and caregivers do to protect children from at least some of the effects of pesticides and herbicides found in/on foods?

• Thoroughly washing and peeling fruits and vegetables helps, but some toxins present while the vegetables and fruits were growing can still be present in the plant.
• Preparing foods less likely to retain pesticide residue following washing/peeling such as onions, avocados, corn, pineapples, mangoes, asparagus, sweet peas, kiwi, cabbage, eggplant, papaya, watermelon, broccoli, tomatoes and sweet potatoes. Some of these have thick skins which are often removed before consumption and which protect the food, while others may be sprayed less as they generally experience less predation by insects.
• Knowing and avoiding fruits and vegetables that have been sprayed with pesticides and purchasing more organic fruits and vegetables can help eliminate 80 percent of the pesticide exposure in foods.  Conventional fruits and vegetables which have the greatest exposure to pesticides include:  Celery, peaches, strawberries, apples, blueberries, nectarines, bell peppers, spinach, kale, cherries, potatoes, grapes, carrots.

Today is World Asthma Day! If you are wondering why this might be important to you and your children, please read this post.  Did you know that 22 million people in the United States are believed to have asthma?  

Six million of those 22 million are children. The National Heart, Lung and Blood Institute of the National Institutes of Health, tells us: "Young children who often wheeze and have respiratory infections--as well as certain other risk factors--are at highest risk of developing asthma that continues beyond 6 years of age. The other risk factors include having allergies, eczema (an allergic skin condition), or parents who have asthma.... Among children, more boys have asthma than girls. Most, but not all, people who have asthma have allergies."[1]

http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhoIsAtRisk.html

Asthma is a chronic lung disease that enflames and narrows the airways--and makes those who suffer from it cough, feel short of breath and experience tightness in their chest.  They may wheeze and even feel as though they need to gasp for air.  Frequently, asthma begins in childhood, and the coughing that is characteristic of asthma may be experienced at night when a child is lying down or often early in the morning on rising.

What happens in asthma is the airways that carry air to and from the lungs become inflamed and swell as they react to substances--such as pollen or pet dander or even exposure to certain chemicals in the air--which can be inhaled. When swollen and sensitive airways react, the muscles that surround them become tighter narrowing the airways and allowing little air to and from the lungs. The mucosal lining of the lungs reacts and may manufacture more mucus making it still more difficult to breathe. 

The symptoms of asthma can manifest themselves each time an airway is inflamed--so it's very good to know if your child has asthma and what triggers an asthma attack.  Sometimes the asthma symptoms described above may go away by themselves if a triggering substance or thing (is removed) or they can be made better by the use of an asthma medicine. 

Asthma attacks are serious and can be life threatening in both adults and children, and they are nothing to be taken lightly.  If you suspect your child may have asthma, an upper-respiratory infection or an allergy that produces asthma-like symptoms, please check with your child's pediatrician.  Your primary care doctor can diagnose asthma based on your child's medical and family histories, a physical exam, and test results.        

Children who have asthma frequently develop symptoms before they reach age 5. And asthma in young children (aged 0 to 5 years) can be difficult to diagnose. It can be difficult to differentiate between asthma or another childhood condition because the symptoms of asthma can occur with other conditions.  A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:

• One or both parents have asthma;
• The child has signs of allergies, including the allergic skin condition eczema;
• The child has allergic reactions to pollens or other airborne allergens;
• The child wheezes even when he or she doesn't have a cold or other infection.

 While asthma cannot be completely cured, most often it can be controlled, but parents need to take a pro-active role in managing a child's asthma.  There are medicines and treatment therapies which do help. 

Cleft lip and palate are birth defects of the upper lip, the roof of the mouth and the soft tissue in the back of the mouth (the soft palate). A cleft occurs when certain body parts and structures do not properly fuse during a baby's development. About 1 in 2,500 people have a cleft palate. Surgery to close the cleft lip is frequently performed when a child is between 6 weeks and 9 months old and additional surgery may be needed later in life if the problem severely affects the nose area. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002046/

According to SmileTrain.org, "Clefts are a major problem in developing countries where there are millions of children who are suffering with unrepaired clefts." Some of those children cannot eat or speak properly and because of their deformity, they frequently aren't allowed to attend school or hold a job. In the U.S., it's hard for us to imagine that kind of heartache, but it's real. The clefts of those children usually go untreated because their families are often too poor to pay for a simple surgery that has been developed for decades.   http://www.smiletrain.org/

There are many causes of cleft lip and palate.  Research shows certain genes are passed down from parents to children (a family history of cleft lip or palate and other birth defect) as well as risk factors such as drugs, viruses, and other toxins. Each of these contributing factors, or one or more of them occurring together, can cause these kinds of birth defects in children. 

There are things parents can do, however, that may help prevent the occurrence of cleft lip and palate. Experts agree that a few basic actions by pregnant mothers especially can help to lower the risk of having a child with these kinds of birth defects.  One major risk factor for cleft lip and palate is smoking.  A woman smoking tobacco during pregnancy has been associated with adverse outcomes, such as low birth weight, pre-term birth, certain diseases in newborns, and with oral cleft defects. 

The increased risk for cleft lip and palate has been estimated at 200 percent when there is maternal smoking during pregnancy.  According to OperationSmile, a worldwide initative dedicated to reducing cleft lip and palate in children, the more cigarettes a mother smokes during pregnancy, the greater the risk. Because tobacco contains nicotine and other substances--such as aromatic hydrocarbons, N nitrosamines, and carbon monoxide--it interferes with normal embryonic and fetal development as the substances are absorbed into the mother's bloodstream and can reach the developing baby.

Consumption of alcohol by pregnant women also has been shown to be another risk factor to normal fetal development. The cells that develop to form the structures of the face may be damaged by a pregnant mother's consumption of alcohol during embryonic development.  Women who drink five or more alcoholic drinks even one day a week--have an increased risk of having a child with isolated oral cleft.

Certain medications when taken during pregnancy are risk factors for giving birth to a child with cleft lip and palate.  Pregnant women should consult their physicians to learn which medications to avoid.  It is well-documented that retinoids, such as Isotretinoin--better known as Accutane used to treat acne--taken even in the first few months of pregnancy can cause severe congenital malformations.  Also anticonvulsants and steroids have been shown to add to the risk of having a child with cleft lip and palate.

Some multivitamin supplements have been shown to help decrease the risk of birth defects, including cleft lip and palate in children. Folic acid taken during pregnancy also can play an important role in a baby's development, especially during the first four months, and has been shown to protect against some cardiovascular and neural defects and may lower the risk of clefting as well.

The good news for parents who have children with cleft lip and palate--in countries like the U.S. and Canada, where it is available--is that surgery can repair the defect.  A child's pediatrician and plastic surgeon can work with parents to help choose the optimum time in a child's development to perform such a repair. It is generally accepted that a cleft lip should be repaired by the time a baby is 3 months old and repairing the partition of mouth and nose as early as possible, between the ages of 12 and 18 months. 

For additional information on cleft lip and palate in children or to find out what you can do to help reduce the risk or provide a smile to a needy child, please visit http://www.operationsmile.org and http://www.SmileTrain.org

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1 Generous thanks to www.SmileTrain.org, PubMed (NIH) and OperationSmile for their good information on Cleft Lip and Palate.

On April 1, 2011, another loud alarm sounded about possible Salmonella contamination in the U.S. This time, the bug was Salmonella Hadar  possibly in poultry, and, in this instance, may have been present in Jennie-O® Turkey burgers.  Jennie-O® of  Wilmar, Minnesota, recalled approximately 55,000 lbs. of frozen and raw ground turkey meat product and the FDA investigation of how the contamination may have occurred continues. However, while FoodSafety.gov calls people's attention the problem--we know that there may still be product on grocery shelves and in home freezers.

To be specific, the Food and Drug Administration's recall notice identified: "The 4-pound boxes of Jennie-O Turkey Store® "All Natural Turkey Burgers with seasonings Lean White Meat,." Each box contains 12 1/3-pound individually wrapped burgers. A use-by date of "DEC 23 2011" and an identifying lot code of "32710" through "32780" are inkjetted on the side panel of each box, just above the opening tear strip. Establishment number "P-7760" is located within the USDA mark of inspection on the front of each box. The products were packaged on Nov. 23, 2010, and were distributed to retail establishments nationwide." 

http://www.cdc.gov/salmonella/hadar0411/040411/index.html

Salmonella is nothing to take lightly.  Symptoms of salmonella infection are diarrhea, fever, and abdominal cramps, which may be experienced 12 to 72 hours after infection. The illness can last from 4 to 7 days, and most people recover without treatment.  The most vulnerable to Salmonella are young children, the elderly, and individuals with compromised immune systems due to disease or other infirmity. A severe Salmonella infection left untreated can cause death. Whether or not we are exposed to this or other strains of Salmonella, it's important to review these food safe handling cautions, especially as warmer weather prevails and the frequency of family camping, picnicking and barbequing picks up speed!  Here are a few food safe handling tips to keep in mind when preparing food for our families:

• Wash your hands, kitchen work surfaces (such as cutting boards and counter tops) and utensils with soap and water immediately after they have had contact with raw meat, poultry or fish; make sure all cooking pots, pans and lids are squeaky clean; disinfect food contact surfaces with a sanitizing agent and rinse away the sanitizing agent completely;
• Cross-contamination of foods can happen easily--do not use the same utensils for different uncooked and cooked foods; make sure to wash utensils that have been used with cooked or uncooked foods, thoroughly;
• Cook meat and poultry thoroughly. When roasting poultry or meat in an oven, the oven temperature should be no lower than 325˚F.
• Invest in a food or "meat" thermometer and cook beef, veal and lamb steaks, roasts, and chops to a safe minimum internal temperature of at least 145°F, pork to 160°F, and ground beef, veal, and lamb to at least 160°F. Poultry should reach a safe minimum internal temperature of at least 165°F throughout the product.
• When reheating foods, they should be reheated thoroughly to an internal temperature of 165 °F or until hot and steaming.
• If you are served uncooked meat or poultry in a restaurant, send it back to the kitchen for additional cooking.
• Very important: Especially if raw meat or poultry have been left unrefrigerated or uncooked for too long, bacteria may grow and produce toxins which can cause foodborne illness. Some toxins are heat resistant and are not destroyed by cooking. Therefore, even though cooked, meat and poultry mishandled in the raw state may not be safe to eat even after proper preparation. Definitely read the food safe handling cautions on packaged meat and poultry.