Does Milk Constipate Kids? (Pedcast)

 

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Doc Smo, your pedcast host here. Welcome to the next installment of portable practical pediatrics.  You’re free pediatric education continues right here at www.docsmo.com. I had an interesting discussion with a family the other day about their five-year-old son who has been chronically constipated. They were concerned about having to give him laxatives almost daily for his chronic constipation.  I agreed with them,  they should have been concerned. The laxative they were giving him has never been tested in children and was intended for short-term use in adults only. After talking about his diet, I discovered that their son loves milk and drinks about 30 ounces a day. I was pretty sure that his large milk intake was causing his constipation and that eliminating much of his dairy would solve his need for laxatives. They couldn’t see the association of lots of dairy intake and constipation so I thought since  this conversation was useful for these parents, maybe my audience would like to hear about the connection between milk and constipation.

I started our “constipation conversation” by posing this question– how do cheese makers make cheese? Well you can imagine I got a rather blank look from these parents because of that question but I knew, understanding this process, would give them a good understanding of why their child was so constipated. Here is the process. First you start with warmed milk (about body temperature) and  blend in some bacteria. Lots of bacteria and some molds. You mix it well, and put that mixture in a warm dark place and you give it some time to grow. Next you add some enzymes that are found in the intestines of cows interestingly enough and cheese starts to form. The longer the fermentation process goes on, the harder the cheese that is  going to be the final product.

Well I think you can see where I was going with this conversation.  The conditions in their sons intestines are exactly the same conditions that are needed to ferment milk into cheese a substance that is thick and hard and very difficult to push through a child’s intestines. For many kids, lots of milk means constipation. This family was having to give their son a daily laxative that chemically bound to water to make his poop wetter and softer, just to allow him to push his poop through his intestines. That’s horrible. Lots of kids have problems with chronic constipation and I think a lot of them simply can’t digest and eliminate cows milk. Milk is not the perfect nutrient for a lot of children, pure and simple.

Additionally since he was not drinking water, his stool was becoming very hard and his intestines were absorbing what little water was left in his poop. His poop therefore became dry and hard. Add a diet high in fat and low in fiber, a sedentary lifestyle, and a lack of access to a bathroom for long periods of time, and you can see why so many children have trouble with chronic constipation.

So here’s what I suggested they do;

  1. Stop most of his milk intake and give him soy milk or almond milk instead.
  2. Increase his water intake and as much as what they could get in them.
  3. Make sure the bathroom is available and easy for him to use even at school.
  4. And finally try and increase his level of physical activity that’s possible.

I haven’t spoken with him since our conversation but I’m pretty sure based on my previous experience with other families that he will not be taking laxatives the next time I see him. Understanding how milk turns into cheese in a child’s intestines and how that can cause constipation is fundamental to understanding a lot of the digestive problems that kids have.
Well I hope that talk was helpful. Thanks for joining me as always. My blog is growing and becoming very popular. For that, I’m very appreciative to you, my audience. Please take a few minutes to subscribe at my website to get and email blast about my the latest content. For you podcasters, subscribe on itunes for new content. As always, I love to hear from you so keep your comments coming. And if you are a big DocSmo junky, get ready for my book that should be available for purchase In March 1st, 2015. I think you are going to love it. This is Doc Smo, hoping you now have the scoop, if your child has trouble with poop. Until next time.

 

 

 

Smo Notes:

 

Intolerance of Cow’s Milk and Chronic Constipation in Children

http://www.nejm.org/doi/full/10.1056/NEJM199810153391602

Pain Reliever and Your Child’s Liver (Article)

 

 

                                                                                           

As is so typical in America, we over emphasize the benefits of medications and we tend to under estimate their potential for harm. Acetaminophen is a perfect example of that tendency. Now we know that one of the most marketed and consumed pain relievers in history, acetaminophen, has the potential to harm those that use it frequently– in large doses, and in combination with other potentially liver toxic medications. Granted, acetaminophen is an extremely useful and safe medication when used occasionally within the proper dose range. There is no disputing that fact. Although mainly therapeutic, acetaminophen has a harmful dark side due to its potential to act as a toxin to the liver of a child or adult.

 

Recently US health authorities advised healthcare providers to stop prescribing “Combination drugs” that have “More than 325 milligrams (mg) of acetaminophen per [unit dosage].” Why, you ask? High concentrations of acetaminophen are known to be able to inflict permanent liver damage can lead to eventual liver transplantation or even death. Rare, yes but not unheard of. By limiting the amount of acetaminophen available in one pill or teaspoon of liquid preparation, this experts hope to make it less likely that the child taking the acetaminophen of any sort, will get near a toxic blood level.

 

 

Physicians and patients are beginning to ask the burning question of “Is acetaminophen now bad for you?” To answer this question, let us listen to the sage advice of the ancient Paracelsus who said,  “All substances are poisons, but the right dose differentiates a poison from a remedy.” Anything can be toxic to your child’s body, from water to any other medication in your medicine cabinet. It is the amount that determines toxicity. It is perfectly all right to use acetaminophen-containing fever reducers and painkillers when your family needs them. The key is not to go overboard, avoid combination medications, and not to give your children a second dose too soon after a previous dose. Our grandparents were right when they told us “Everything in moderation”. Only give your children medications that they absolutely need and at the lowest dose possible. All medications have the potential to do harm to your children which is the last thing in the world you want to do!

 

Your comments, stories, and wisdom are welcome at my blog, www.docsmo.com. Take a few minutes to share your thoughts. Until next time.

 

Smo Notes:

 

  1.  Reuters News agencyFDA asks doctors to limit acetaminophen in combination drugshttp://www.reu…0E01520140115

 

Written collaboratively by Norman Spencer PhD and Paul Smolen MD

 

 

 

Codeine Cough Syrup Warning (Article)

 

Recently, a hot topic in healthcare has been the growing realization that some of the standard therapies that have been used for decades may in fact be dangerous. For instance, a common occurrence is when a worried parent takes his or her child into the pediatrician with a cold and expects a prescription for an antibiotic. Pediatricians, often relent and prescribe in this situation, even though the medication may be unnecessary. A similar event seems to be occurring with codeine cough syrups, used for decades in children, but now contraindicated in children due to a rare but deadly side effect in young children. Most doctors treating children are aware of this new information but many are still prescribing it!

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Car Seats Done Right (Article)

Cars can be dangerous for children, especially considering the vast amount of time they spend in and around them. This fact is borne out by statistics, year in and year out. In 2011 for instance, 148,000 children were injured in automobile accidents. A third of these children were not restrained by a car seat or seatbelt at the time of their injury. Amazing. Intoxicated drivers, poorly installed car seats, and simple carelessness make injuries and death of children in cars mostly preventable. Continue reading

Home Remedies, S.C. Style (Pedcast)

 

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Today, I have something really unique for you… I am going to introduce you to Tamika Hinton, my office assistant. I recently discovered that she is a wealth of information about home remedies for common ailments… that is, folk remedies, South Carolina style remedies. She is also a wonderful person, full of life and cheer, who grew up in the small SC town of Rock Hill. We were talking the other day and she started telling me about some of her families home remedies she recalled from her childhood. I found them so interesting that I had to share them with my viewers, along with some of Tamika’s childhood memories. So today, I’m going to share with you some of Tamika Hinton’s Home Remedies, South Carolina Style.

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New Treatment for Migraine (Article)

If you are one of the 37 million Americans who suffer from migraines, you know the symptoms all too well: pounding pain in a specific area in your head, nausea, and sensitivity to light and sound. You continually reach for the Advil to relieve your pain, but it doesn’t always work, or sometimes even causes additional discomfort from side effects. Some other prescription anti-migraine drugs have side effects that numerous patients can’t handle. For example, pregnant women, women who certainly require relief from migraines, often cannot take some of these drugs because some cause birth defects and other potential side effects of the medicines. Shouldn’t there be a more effective, less risky solution? Now there is for adult migraine sufferers and hopefully children as well soon.

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How to Talk So Kids Will Listen, By Farber/Mazlish (Book Review Pedcast)

 

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Doc Smo here, your pedcast host. Thanks for joining me today. I have another book review for you today that I think you will find interesting. In fact, I know you will find it interesting.  It is actually an older book titled, “How to Talk So Kids Will Listen”, by Adele Farber and Elaine Mazlish. I have seen it on lists of “must read” parenting books and frankly, after my read, I agree with that assessment. Let’s go under the hood and break down some of this book’s main points, shall we?

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Good News on Baby Shots, But… (Article)

We still have more children to immunize as the recent Disney measles outbreak demonstrates, but there is great cause for celebration by pediatricians and public health officials: vaccination rates among young children are actually quite high. From 2012-2013, many of the most important vaccines for young children such as the measles vaccine (MMR), hepatitis B vaccine, poliovirus vaccine, and chicken pox vaccine have been administered to over 90% of children aged 19 -35 months. It is estimated that this level of vaccination in children born between 1994 and 2013 will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths during these children’s lifetimes.  What a tremendous achievement! But it is too early to rest on our laurels. In order to get the maximum benefit from vaccines for our children, we need to continue to improve vaccine delivery for every child. Currently, we are having problems getting the children of families with either very low and very high incomes vaccinated.
 
Even though vaccine coverage is increasing for most children, a recent National Immunization Survey (1) indicates that many children who live below the poverty line are not getting all the vaccines they need in a timely fashion. This problem is especially evident in rates of follow-up vaccines for those vaccines that require more than one round of treatment, such as DTaP (for diphtheria, tetanus, and whooping cough) and PCV (for prevention of pneumococcal infections). Children in lower income households frequently miss their wellness check-ups that are crucial in delivering vaccines, thus contributing to the decline. Purposeful steps must be taken to ensure that these children do not fall through the cracks.
 
Thankfully, there are new programs and systems available to boost vaccine rates in children. The “Vaccines for Children” program has reduced the disparity in vaccination rates for children in lower income households by providing free vaccines to private doctors who provide services to lower income families. Educating parents on the risks of missed vaccines and the long-term benefits of proper vaccination for their children is also key to increasing vaccine rates. Hopefully, the recent surge in cases of measles will serve as a reminder to parents to get their children immunized. Finally, it is hoped that by using national media campaigns, telephone reminder systems, and computer-based vaccine databases, parents and doctors will decrease the missed opportunities to vaccinate. If your child or the child of someone you know has missed a vaccine, schedule an appointment with your child’s doctor as soon as possible. Let’s raise that vaccine rate to a nice even 100%, shall we? With everyone’s help, we can.
 
Your comments are welcome at my blog, www.docsmo.com. Until next time.
 
Smo Notes:
 
1. National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2013
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6334a1.htm?s_cid=mm6334a1_e
2. Rich People in Hollywood aren’t Vaccinating their Children, by Kara Brown, September 2014
http://jezebel.com/rich-people-in-hollywood-arent-vaccinating-their-childr-1633139304
Written collaboratively by Keri Register and Paul Smolen M.D.

How Long is Too Long for a Cold? (Pedcast)

 

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I was browsing some articles the other day and came across a gem that I thought changed my understanding of disease and one that you might be interested in. The topic was a scientific estimates of the length, in time, of respiratory symptoms in children.

Why is this important you ask?  Well, doctors use these estimates to guide treatment… we are taught that if a cold last more than 10 days that means the child likely has a bacterial Continue reading

Overweight Kids Misperceive their Weight (Article)

Overweight children who do not perceive themselves as overweight are much less likely to make changes in their life that would improve their body proportions. This is the conclusion of experts who have been studying the obesity epidemic in the U.S. Recent studies have found that children who see themselves as overweight or obese are more likely to get in shape by eating whole foods and exercising. Unfortunately, the same research found that 76% of overweight youth and 41.9% of obese youth age 8 to 15 years old consider themselves to be Continue reading

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