Television Viewing Associated With Increased Combative Behavior In Young Children

Recent research suggests that television watching is related to hostile behavior in children under the age of three. While investigators in the current study (published in the November issue of the Archives of Pediatrics and Adolescent Medicine) found that young children who received corporal punishment, resided in a dangerous community, or had a mother who was distressed or under mental pressure were more likely to display aggressive behaviors, they also found that television viewing (both direct and indirect) had a statistically meaningful effect on children’s aggression.

The study, conducted by Dr. Jennifer Manganello- an assistant professor of health communication at the University of Albany School of Public Health- provides results from an analysis of national data collected for over 3,000 children born between 1998 and 2000. Because so many variables can impact a child’s actions, the investigators attempted to control for as many variables as possible, including maternal parenting beliefs, maternal experience with violence, the security of family surroundings and demographic characteristics. Even after weighting for these variables, television was more likely than many other factors to elevate aggressive behaviors.

The American Academy of Pediatrics (AAP) is disturbed enough about the media’s impact on the behavior of young children that they recently refreshed their protocol on media brutality:

“Exposure to violence in media, including television, movies, music and video games, represents a significant risk to the health of children and adolescents. Extensive research evidence indicates that media violence can contribute to aggressive behavior, desensitization to violence, nightmares and fear of being harmed,” wrote the AAP Council on Communications and Media.

According to Richard Gallagher, director of the Parenting Institute at the New York University Child Study Center in New York City, television is not a harmless instrument- it does have an impact on children and families. While media subject matter may influence actions, Gallagher suggests that children’s behaviors may also be influenced by “opportunities lost.”

In other words, when an infant or toddler is viewing a television show, which is an inactive behavior, the child does not have the occasion to engage with other family members and may have decreased interaction with his or her companions. “The AAP guidelines that children under 2 shouldn’t watch any television may be fairly strict and hard to carry out, but parents should be judicious about how much TV young children are watching, and be aware that it’s not likely to be appropriately stimulating,” stated Gallagher.

Parents should operate as a television “purifier” for their young children. For instance, moms and dads should indicate when something is nonsensical on television and that it is not a real-world situation. Also, if they happen to see something disturbing or violent- even in a television show designed for children- parents need to translate that situation for children, and inform them of what would happen if that were a real scenario.

For more resources on parenting and early child development, please visit The Urban Child Institute’s Parenting Resources webpage at http://www.theurbanchildinstitute.org/Parenting.

References

Gordon, S. (2009, November 2). TV may increase aggression in toddlers: The more watched, the more aggressive the behavior, study finds. HealthDay Reporter.
http://www.healthday.com/Article.asp?AID=632720

New Research Links Tobacco Exposure During Pregnancy to Various Neuro-developmental Problems in Early Childhood

According to new research presented at the 2009 American Academy of Child and Adolescent Psychiatry Annual Meeting, tobacco exposure during pregnancy has been found to be associated with disagreeableness in very young infants, inadequate concentration and information synthesizing during the first year of life, as well as impulsivity during the preschool years.

“We found that even in the first year of life, we can see differences in attention and irritability and in the regulation of emotions…Then at age 3, we saw that kids with prenatal tobacco exposure seem to have trouble waiting for an award, which ties in with findings that smoking during pregnancy can have a specific impact on the parts of the brain that are involved in regulating behavior, ''stated Dr. Sandra A. Wiebe, lead investigator and professor at the University of Alberta, Canada.

An estimated 10% to 30% of females in the United States use tobacco during pregnancy (Brauser, 2009). Last year in Tennessee, over 16,000 (18.8%) of mother’s giving birth in our state reported cigarette smoking during pregnancy . Over 1,100 (6.9%) of the birth mother’s reporting cigarette smoking during pregnancy gave birth in Shelby County (TN DOH, 2009).

Dr. Wiebe acknowledges that it can be difficult for mothers to quit smoking; however, she believes that information and education on the effects of prenatal tobacco exposure can help encourage moms to abstain. “We need to explain that it can affect how well a baby learns about the world, as well as how well they’re able to behave adaptively in various situations once they start preschool or kindergarten,” she suggested.

Local Resources

The Church Health Center's Hope and Healing Center offers health and wellness programs including weight loss classes and smoking cessation counseling. Their Freedom From Smoking program is eight weeks of group counseling designed to help participants kick the smoking habit. They offer sliding scale membership fees based on income and family size. For more information, please call 901-259-4673.

For more information on the well-being of young children in Memphis and Shelby County, please visit The Urban Child Institute website at http://www.theurbanchildinstitute.org/Home/.

References

Brauser, D. (2009, November 9). Prenatal tobacco exposure linked to multiple problems. Medscape Medical News.

Tennessee Department of Health, Division of Health Statistics. Personal Communication, November 12, 2009.

Following AAP, the American Dietetic Association Supports Exclusive Breastfeeding For 6 Months

According to a recent policy report released by the American Dietetic Association (ADA), breastfeeding provides health advantages to both mothers and babies; thus, the use of human milk for infant feeding should be advanced and applauded.

“It is the position of the American Dietetic Association that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods from 6 months until at least 12 months of age is the ideal feeding pattern for infants. Breastfeeding is an important public health strategy for improving infant and child morbidity and mortality and improving maternal morbidity and helping to control health care costs,” the ADA stated in a press release.

The recommendations of the ADA mimic the breastfeeding policy statement of the American Academy of Pediatrics (AAP). The AAP recommends exclusive breastfeeding for six months after birth, continuous breastfeeding for at least 12 months after birth, and thereafter as long as mutually desired (AAP, 2005).

The authors of the policy report developed a science-based examination on the framework of breastfeeding customs and health advantages in the United States and in other nations. They determined that human milk supplies superlative nutrient content for very young children and weakens the possibility of developing multiple serious and enduring conditions.

The health advantages for babies include:

- A sound immune system

- Reduced possibility of developing asthma, lower respiratory tract complications and gastroenteritis

- Elevated defense against allergies and sensitivities

- Appropriate growth of teeth and jaw

- Correlation with increased IQ and improved educational achievement

- Decreased risk for SIDS, as well as recurrent illnesses, including weight issues, diabetes, heart problems, elevated blood pressure, high cholesterol and childhood cancer

The ADA suggests that dietetic specialists and registered dietitians maintain a critical role in endorsing and fostering breastfeeding for its health advantages for children and families. Additionally, dietary professionals also have a crucial position in administering pragmatic research on breastfeeding-related matters. The authors suggest that more research on breastfeeding promotion campaigns is of particularly high priority.

For more information on the current Shelby County breastfeeding campaign, please contact Dr. Julie Ware (President of the Shelby County Breastfeeding Coalition) at julieware2@bellsouth.net. The Shelby County Breastfeeding Coalition is a county-wide collaboration that aims to implement national breastfeeding policy recommendations. The collaborative consists of nine organizations and represents a partnership between the public and private sectors, as well as uniting the community with medical, academic, public health, research, and business groups.

For more information on the well-being of young children in Memphis and Shelby County, please visit The Urban Child Institute at http://www.theurbanchildinstitute.org/Home.

References
American Academy of Pediatrics. (2005). Policy statement: Breastfeeding and the use of human milk. Pediatrics, 115 (2).

Breastfeeding benefits moms and babies: Report. (2009, November 6). Healthday: Yahoo!News.
http://news.yahoo.com/s/hsn/20091107/hl_hsn/breastfeedingbenefitsmomsandbabiesreport

Flu Vaccination During Pregnancy: An Effective Way to Help Improve the Health of Memphis Babies

With the very real concerns surrounding the flu this winter, many of us are wondering if it is safe for pregnant women to get the flu shot.

Research that was recently presented at the Infectious Diseases Society of America meeting found that getting a flu vaccine during pregnancy greatly improves a child’s chances of having healthy birth outcomes. The researchers examined the effect of having a regular flu vaccination and not the H1N1 vaccination. However, the CDC does recommend that all pregnant women receive the swine flu vaccine as well (CDC, 2009, November).

Why does vaccination help? Pregnant women are especially vulnerable to infectious diseases like the flu because their immune systems are depressed in order to protect their developing babies. Additionally, infants cannot be vaccinated against the flu for the first 6 months of life, so they are vulnerable unless they have received the vaccination second hand while they are in utero (Fox, 2009, October 29).

Specifically, the studies have revealed that flu vaccination during pregnancy at the height of the flu season can reduce an infant’s chances of being hospitalized in the first 6 months of life by up to 85%. Pregnant women who were vaccinated against the flu were also 80% less likely to have a premature birth and 70% less likely to have a baby that was small for gestational age. Their babies, on average, were a half pound heavier than those of unvaccinated women (Fox, 2009, October 29).

Sources

Fox, M. (October 29, 2009). When Moms Get Flu Shot, Babies Benefit Too: Study, ABC News. http://abcnews.go.com/Health/wireStory?id=8951864

Centers for Disease Control. 2009 H1N1 Influenza Shots and Pregnant Women: Questions and Answers for Patients. http://www.cdc.gov/h1n1flu/vaccination/pregnant_qa.htm

New Study Estimates That 50% Of Our Nation’s Children Will Receive Food Stamps Before Their Eighteen Birthday

Recent estimates from researchers at Washington University in Saint Louis suggest that almost half of our country’s children (and a staggering 9 out of 10 African American children) will receive food-related governmental assistance at some point during the first eighteen years of life. The study, released earlier this week in the November issue of Archives of Pediatrics and Adolescent Medicine, states that repercussions from the recent economic crisis could heighten these numbers dramatically.

Lead investigator and sociologist Mark Rank cautions that this increase is a health issue that the medical community needs to be mindful of given that children on food assistance are at risk for dietary deficiency and other afflictions related to economic deprivation, including insufficient cognitive, social and emotional development. “This is a real danger sign that we as a society need to do a lot more to protect children, “ Rank advised (Tanner, 2009, p. 1).

According to a federal brief released last month from the United States Department of Agriculture, almost 29 million citizens received food stamps in a typical month last year, and about 50% of these recipients were children. Food stamps are a government-run program for low-income families, covering many food items (with the exclusion of prepared hot items and alcohol).

In Shelby County, over 233,000 individuals (26% of the county’s population) were receiving food stamps as of June of this year (TN Department of Human Services, 2009). Approximately 63,000 (27%) of these recipients are under 18 years of age. In other words, about one in four Shelby County children are currently obtaining food-related assistance (CUCP estimate, see footnote). Furthermore, according to recent information released by the Tennessee Department of Education, approximately 86% of students currently enrolled in the Memphis City school system are from families who meet certain income criteria making them eligible to receive free or reduced price lunch (TDOE, 2009).

This research is consistent with other current studies that estimate that upwards of 40 percent of our nation’s children will reside in impoverished or low-income families by their late teenage years, and that one in two will at some point live in a household that is headed by a single parent (Tanner, 2009).

“The current recession is likely to generate for children in the United States the greatest level of material deprivation that we will see in our professional lifetimes,” stated Stanford pediatrician Dr. Paul Wise. “I find it terribly sad, but not surprising.”

In the midst of our current dire economic climate, what can the Memphis community do to support the healthy development of our youngest citizens? We welcome your thoughts, comments and suggestions.

For more information on the well-being of children in Memphis and Shelby County, please visit The Urban Child Institute website at http://www.theurbanchildinstitute.org.

References
Tanner, L. (2009, November 3). Half of U.S. kids will get food stamps, study says. The Associated Press.

Tennessee Department of Education, 2009,
http://edu.reportcard.state.tn.us/pls/apex/f?p=200:1:829762500068372

Tennessee Department of Human Services. (2009, September). Tennessee Monthly Food Stamp
Participation. Nashville, TN: Author.

CUCP estimate: Please contact us at cucp@theurbanchildinstitute.org for more information.

Premature Births Lift U.S. Infant Mortality Rate

The Wall Street Journal reported this week on a new study from the Centers for Disease Control and Prevention that examines the link between prematurity and infant mortality around the world. (The U.S. ranks 30th in the world in terms of infant mortality rates).

The study concludes that premature births, which are often due to poor prenatal care of low-income pregnant women, are the main reason the U.S. infant mortality rate is higher than in most European countries.

About 1 in 8 U.S. births are premature. Early births are much less common across most of Europe; for example, only 1 in 18 babies are premature in Ireland and Finland.

Poor access to prenatal care, maternal obesity and smoking, too-early cesarean sections and induced labor and fertility treatments are among the reasons for preterm births, experts said.

Premature babies born before 37 weeks tend to be more fragile and have under-developed lungs, said the lead author of the new report, Marian MacDorman of the U.S. Centers for Disease Control and Prevention.

Premature births are the chief reason the U.S. has an infant mortality rate more than twice as high as infant mortality rates in Sweden, Japan, Finland, Norway and the Czech Republic.

If U.S. infants were as mature as Sweden's are at birth, nearly 8,000 infant deaths could be avoided and the U.S. infant mortality rate would be about one-third lower than it is, according to a calculation by Ms. MacDorman and others at the CDC's National Center for Health Statistics.

Why so many more premature infants here? Experts offered several possible explanations:

■Fertility treatments and other forms of assisted reproduction probably play a role because they often lead to twins, triplets or other multiple births. Those children tend to be delivered early.
■The U.S. health care system doesn't guarantees prenatal care to pregnant women, particularly the uninsured, said Alan R. Fleischman, medical director for the March of Dimes.
■Maternal obesity and smoking have been linked to premature births and may also be a factor.
■Health officials are also concerned that doctors increasingly are inducing labor or performing C-sections before the 37th week. However, Fleischman said most infant deaths do not occur in babies just shy of 37 weeks gestation, but rather in those much younger,
Labor was induced in nearly 16% of premature births in 2006, up from about 8% in 1991. Cesarean sections were done in 36% of preterm births, up from 25% in 1991, Ms. MacDorman said.


The report also found that while the U.S. more commonly saw premature births, survival rates for infants at that gestational age were as good or better than most European countries.

"So, once the baby is born too early, we do a good job of saving it. What we have trouble with is preventing the preterm birth in the first place," Ms. MacDorman said.

Improving Infant and Toddler Care: Considerations from the National Center for Children In Poverty

Careful research shows that better prepared family care providers offer our youngest children higher-quality care. In order to improve the cognitive, social and emotional development of infants and toddlers, policy leaders have instituted training and education qualifications for licensed providers and designed multiple initiatives to prepare and inform early care staff.

So what works? What types of education are most effective in advancing the quality of family child care homes and centers? Researchers from the National Center for Children in Poverty (2005) reviewed a wide body of literature on training methods for early care providers and provide the following summaries for professionals and policy-makers:

- Coursework that provides higher education credits and is supplemented with technical support seems to enhance quality in the early care setting, particularly for family care providers. Caregivers receiving technical assistance demonstrated higher quality scores in language/reasoning and basic/personal care.

- Noncredit training has a greater impact on caregivers who have no affiliation with a professional organization (such as the National Association for the Education for Young Children) than on affiliated providers. Prior to training, affiliated providers typically have higher observed levels of quality than unaffiliated providers.

- Scholarships providing enrollment in community college-level coursework in child development appear to increase overall quality ratings in center-based providers.

- Long-term, personalized coaching for caregivers can improve early care quality. Infant caregivers involved in mentoring programs have demonstrated improved quality in discipline techniques, sensitivity and learning activities.

More research needs to be done on infant and toddler caregiver training and education. What we do know is that training methods need to match the particular types of providers, and trainers need to be ready to make adjustments as the research advances.

For more information on the well-being of children in Memphis and Shelby County, please visit The Urban Child Institute at http://www.theurbanchildinstitute.org.

References

Kreader, J., Ferguson, D., & Lawrence, S. (2005, August). Impact of training and education for caregivers of infants and toddlers (Research-To-Policy No. 3). National Center for Children In Poverty.